_h7141_

HB 7141

1	A bill to be entitled
2	An act relating to the licensure of health care providers;
3	creating pts. I, II, III, and IV of ch. 408, F.S.;
4	creating s. 408.801, F.S.; providing a short title;
5	providing legislative findings and purpose; creating s.
6	408.802, F.S.; providing applicability; creating s.
7	408.803, F.S.; providing definitions; creating s. 408.804,
8	F.S.; requiring providers to have and display a license;
9	providing limitations; creating s. 408.805, F.S.;
10	establishing license fees and conditions for assessment
11	thereof; providing a method for calculating annual
12	adjustment of fees; providing for inspection fees;
13	providing that fees are nonrefundable; creating s.
14	408.806, F.S.; providing a license application process;
15	requiring specified information to be included on the
16	application; requiring payment of late fees under certain
17	circumstances; requiring inspections; providing an
18	exception; authorizing the Agency for Health Care
19	Administration to establish procedures and rules for
20	electronic transmission of required information; creating
21	s. 408.807, F.S.; providing procedures for change of
22	ownership; requiring the transferor to notify the agency
23	in writing within a specified time period; providing for
24	duties and liability of the transferor; providing for
25	maintenance of certain records; creating s. 408.808, F.S.;
26	providing license categories and requirements therefor;
27	creating s. 408.809, F.S.; requiring background screening
28	of specified employees; providing for submission of proof
29	of compliance, under certain circumstances; providing
30	conditions for granting provisional and standard licenses;
31	providing an exception to screening requirements; creating
32	s. 408.810, F.S.; providing minimum licensure
33	requirements; providing procedures for discontinuance of
34	operation and surrender of license; requiring forwarding
35	of client records; requiring publication of a notice of
36	discontinuance of operation of a provider; providing for
37	statewide toll-free telephone numbers for reporting
38	complaints and abusive, neglectful, and exploitative
39	practices; requiring proof of legal right to occupy
40	property, proof of insurance, and proof of financial
41	viability, under certain circumstances; requiring
42	disclosure of information relating to financial
43	instability; providing a penalty; prohibiting the agency
44	from licensing a health care provider that does not have a
45	certificate of need or an exemption; creating s. 408.811,
46	F.S.; providing for inspections and investigations to
47	determine compliance; providing that inspection reports
48	are public records; requiring retention of records for a
49	specified period of time; creating s. 408.812, F.S.;
50	prohibiting certain unlicensed activity by a provider;
51	requiring unlicensed providers to cease activity;
52	providing penalties; requiring reporting of unlicensed
53	providers; creating s. 408.813, F.S.; authorizing the
54	agency to impose administrative fines; creating s.
55	408.814, F.S.; providing conditions for the agency to
56	impose a moratorium or emergency suspension on a provider;
57	requiring notice; creating s. 408.815, F.S.; providing
58	grounds for denial or revocation of a license or change-
59	of-ownership application; providing conditions to continue
60	operation; exempting renewal applications from provisions
61	requiring the agency to approve or deny an application
62	within a specified period of time, under certain
63	circumstances; creating s. 408.816, F.S.; authorizing the
64	agency to institute injunction proceedings, under certain
65	circumstances; creating s. 408.817, F.S.; providing basis
66	for review of administrative proceedings challenging
67	agency licensure enforcement action; creating s. 408.818,
68	F.S.; requiring fees and fines related to health care
69	licensing to be deposited into the Health Care Trust Fund;
70	creating s. 408.819, F.S.; authorizing the agency to adopt
71	rules; providing a timeframe for compliance; creating s.
72	408.820, F.S.; providing exemptions from specified
73	requirements of pt. II of ch. 408, F.S.; amending s.
74	400.801, F.S.; providing that the definition of homes for
75	special services applies to sites licensed by the agency
76	after a certain date; amending s. 408.831, F.S.; revising
77	provisions relating to agency action to deny, suspend, or
78	revoke a license, registration, certificate, or
79	application; conforming cross-references; providing for
80	priority of application in case of conflict; authorizing
81	the agency to adjust annual licensure fees to provide
82	biennial licensure fees; requesting interim assistance of
83	the Division of Statutory Revision to prepare conforming
84	legislation for the 2007 Regular Session; authorizing the
85	agency to issue licenses for less than a specified time
86	period and providing conditions therefor; providing an
87	effective date.
88
89	Be It Enacted by the Legislature of the State of Florida:
90
91	Section 1. Part I of chapter 408, Florida Statutes,
92	consisting of sections 408.031, 408.032, 408.033, 408.034,
93	408.035, 408.036, 408.0361, 408.037, 408.038, 408.039, 408.040,
94	408.041, 408.042, 408.043, 408.044, 408.045, 408.0455, 408.05,
95	408.061, 408.062, 408.063, 408.07, 408.08, 408.09, 408.10,
96	408.15, 408.16, 408.18, 408.185, 408.20, 408.301, 408.302,
97	408.40, 408.50, 408.70, 408.7056, 408.7057, and 408.7071,
98	Florida Statutes, is created and entitled "Health Facility and
99	Services Planning."
100	Section 2. Part II of chapter 408, Florida Statutes,
101	consisting of sections 408.801, 408.802, 408.803, 408.804,
102	408.805, 408.806, 408.807, 408.808, 408.809, 408.810, 408.811,
103	408.812, 408.813, 408.814, 408.815, 408.816, 408.817, 408.818,
104	408.819, 408.820, and 408.831, Florida Statutes, is created and
105	entitled "Health Care Licensing: General Provisions."
106	Section 3. Part III of chapter 408, Florida Statutes,
107	consisting of sections 408.90, 408.901, 408.902, 408.903,
108	408.904, 408.905, 408.906, 408.907, 408.908, and 408.909,
109	Florida Statutes, is created and entitled "Health Insurance
110	Access."
111	Section 4. Part IV of chapter 408, Florida Statutes,
112	consisting of sections 408.911, 408.913, 408.914, 408.915,
113	408.916, 408.917, and 408.918, Florida Statutes, is created and
114	entitled "Health and Human Services Eligibility Access System."
115	Section 5. Sections 408.801, 408.802, 408.803, 408.804,
116	408.805, 408.806, 408.807, 408.808, 408.809, 408.810, 408.811,
117	408.812, 408.813, 408.814, 408.815, 408.816, 408.817, 408.818,
118	408.819, and 408.820, Florida Statutes, are created to read:
119	408.801 Short title; purpose.--
120	(1) This part may be cited as the "Health Care Licensing
121	Procedures Act."
122	(2) The Legislature finds that there is unnecessary
123	duplication and variation in the requirements for licensure by
124	the agency. It is the intent of the Legislature to provide a
125	streamlined and consistent set of basic licensing requirements
126	for all such providers in order to minimize confusion,
127	standardize terminology, and include issues that are otherwise
128	not adequately addressed in the Florida Statutes pertaining to
129	specific providers.
130	408.802 Applicability.--The provisions of this part apply
131	to the provision of services that require licensure as defined
132	in this part and to the following entities licensed, registered,
133	or certified by the agency, as described in chapters 112, 383,
134	390, 394, 395, 400, 440, 483, and 765:
135	(1) Laboratories authorized to perform testing under the
136	Drug-Free Workplace Act, as provided under ss. 112.0455 and
137	440.102.
138	(2) Birth centers, as provided under chapter 383.
139	(3) Abortion clinics, as provided under chapter 390.
140	(4) Crisis stabilization units, as provided under parts I
141	and IV of chapter 394.
142	(5) Short-term residential treatment facilities, as
143	provided under parts I and IV of chapter 394.
144	(6) Residential treatment facilities, as provided under
145	part IV of chapter 394.
146	(7) Residential treatment centers for children and
147	adolescents, as provided under part IV of chapter 394.
148	(8) Hospitals, as provided under part I of chapter 395.
149	(9) Ambulatory surgical centers, as provided under part I
150	of chapter 395.
151	(10) Mobile surgical facilities, as provided under part I
152	of chapter 395.
153	(11) Private review agents, as provided under part I of
154	chapter 395.
155	(12) Health care risk managers, as provided under part I
156	of chapter 395.
157	(13) Nursing homes, as provided under part II of chapter
158	400.
159	(14) Assisted living facilities, as provided under part
160	III of chapter 400.
161	(15) Home health agencies, as provided under part IV of
162	chapter 400.
163	(16) Nurse registries, as provided under part IV of
164	chapter 400.
165	(17) Companion services or homemaker services providers,
166	as provided under part IV of chapter 400.
167	(18) Adult day care centers, as provided under part V of
168	chapter 400.
169	(19) Hospices, as provided under part VI of chapter 400.
170	(20) Adult family-care homes, as provided under part VII
171	of chapter 400.
172	(21) Homes for special services, as provided under part
173	VIII of chapter 400.
174	(22) Transitional living facilities, as provided under
175	part VIII of chapter 400.
176	(23) Prescribed pediatric extended care centers, as
177	provided under part IX of chapter 400.
178	(24) Home medical equipment providers, as provided under
179	part X of chapter 400.
180	(25) Intermediate care facilities for persons with
181	developmental disabilities, as provided under part XI of chapter
182	400.
183	(26) Health care services pools, as provided under part
184	XII of chapter 400.
185	(27) Health care clinics, as provided under part XIII of
186	chapter 400.
187	(28) Clinical laboratories, as provided under part I of
188	chapter 483.
189	(29) Multiphasic health testing centers, as provided under
190	part II of chapter 483.
191	(30) Organ and tissue procurement agencies, as provided
192	under chapter 765.
193	408.803 Definitions.--As used in this part, the term:
194	(1) "Agency" means the Agency for Health Care
195	Administration, which is the licensing agency under this part.
196	(2) "Applicant" means an individual, corporation,
197	partnership, firm, association, or governmental entity that
198	submits an application for a license to the agency.
199	(3) "Authorizing statute" means the statute authorizing
200	the licensed operation of a provider listed in s. 408.802 and
201	includes chapters 112, 383, 390, 394, 395, 400, 440, 483, and
202	765.
203	(4) "Certification" means certification as a Medicare or
204	Medicaid provider of the services that require licensure, or
205	certification pursuant to the federal Clinical Laboratory
206	Improvement Amendment (CLIA).
207	(5) "Change of ownership" means an event in which the
208	licensee changes to a different legal entity or in which 45
209	percent or more of the ownership, voting shares, or controlling
210	interest in a corporation whose shares are not publicly traded
211	on a recognized stock exchange is transferred or assigned,
212	including the final transfer or assignment of multiple transfers
213	or assignments over a 2-year period that cumulatively total 45
214	percent or greater. A change solely in the management company or
215	board of directors is not a change of ownership.
216	(6) "Client" means any person receiving services from a
217	provider listed in s. 408.802.
218	(7) "Controlling interest" means:
219	(a) The applicant or licensee;
220	(b) A person or entity that serves as an officer of, is on
221	the board of directors of, or has a 5-percent or greater
222	ownership interest in the applicant or licensee; or
223	(c) A person or entity that serves as an officer of, is on
224	the board of directors of, or has a 5-percent or greater
225	ownership interest in the management company or other entity,
226	related or unrelated, with which the applicant or licensee
227	contracts to manage the provider.
228
229	The term does not include a voluntary board member.
230	(8) "License" means any permit, registration, certificate,
231	or license issued by the agency.
232	(9) "Licensee" means an individual, corporation,
233	partnership, firm, association, or governmental entity that is
234	issued a permit, registration, certificate, or license by the
235	agency. The licensee is legally responsible for all aspects of
236	the provider operation.
237	(10) "Moratorium" means a prohibition on the acceptance of
238	new clients.
239	(11) "Provider" means any activity, service, agency, or
240	facility regulated by the agency and listed in s. 408.802.
241	(12) "Services that require licensure" means those
242	services, including residential services, that require a valid
243	license before those services may be provided in accordance with
244	authorizing statutes and agency rules.
245	(13) "Voluntary board member" means a board member of a
246	not-for-profit corporation or organization who serves solely in
247	a voluntary capacity, does not receive any remuneration for his
248	or her services on the board of directors, and has no financial
249	interest in the corporation or organization. The agency shall
250	recognize a person as a voluntary board member following
251	submission of a statement to the agency by the board member and
252	the not-for-profit corporation or organization that affirms that
253	the board member conforms to this definition. The statement
254	affirming the status of the board member must be submitted to
255	the agency on a form provided by the agency.
256	408.804 License required; display.--
257	(1) It is unlawful to provide services that require
258	licensure, or operate or maintain a provider that offers or
259	provides services that require licensure, without first
260	obtaining from the agency a license authorizing the provision of
261	such services or the operation or maintenance of such provider.
262	(2) A license must be displayed in a conspicuous place
263	readily visible to clients who enter at the address that appears
264	on the license and is valid only in the hands of the licensee to
265	whom it is issued and may not be sold, assigned, or otherwise
266	transferred, voluntarily or involuntarily. The license is valid
267	only for the licensee, provider, and location for which the
268	license is issued.
269	408.805 Fees required; adjustments.--Unless otherwise
270	limited by authorizing statutes, license fees must be reasonably
271	calculated by the agency to cover its costs in carrying out its
272	responsibilities under this part, authorizing statutes, and
273	applicable rules, including the cost of licensure, inspection,
274	and regulation of providers.
275	(1) Licensure fees shall be adjusted to provide for
276	biennial licensure under agency rules.
277	(2) The agency shall annually adjust licensure fees,
278	including fees paid per bed, by not more than the change in the
279	Consumer Price Index based on the 12 months immediately
280	preceding the increase.
281	(3) The agency may, by rule, adjust licensure fees to
282	cover the cost of administering this part, authorizing statutes,
283	and applicable rules.
284	(4) An inspection fee must be paid as required in
285	authorizing statutes.
286	(5) Fees are nonrefundable.
287	(6) When a change is reported that requires issuance of a
288	license, a fee may be assessed. The fee must be based on the
289	actual cost of processing and issuing the license.
290	(7) A fee may be charged to a licensee requesting a
291	duplicate license. The fee may not exceed the actual cost of
292	duplication and postage.
293	(8) Total fees collected may not exceed the cost of
294	administering this part, authorizing statutes, and applicable
295	rules.
296	408.806 License application process.--
297	(1) An application for licensure must be made to the
298	agency on forms furnished by the agency, submitted under oath,
299	and accompanied by the appropriate fee in order to be accepted
300	and considered timely. The application must contain information
301	required by authorizing statutes and applicable rules and must
302	include:
303	(a) The name, address, and social security number of the
304	applicant and each controlling interest if the applicant or
305	controlling interest is an individual.
306	(b) The name, address, and federal employer identification
307	number or taxpayer identification number of the applicant and
308	each controlling interest if the applicant or controlling
309	interest is not an individual.
310	(c) The name by which the provider is to be known.
311	(d) The total number of beds or capacity requested, as
312	applicable.
313	(e) The name of the person or persons under whose
314	management or supervision the provider will operate and the name
315	of the administrator, if required.
316	(f) If the applicant offers continuing care agreements as
317	defined in chapter 651, proof shall be furnished that the
318	applicant has obtained a certificate of authority as required
319	for operation under chapter 651.
320	(g) Other information, including satisfactory inspection
321	results, that the agency finds necessary to determine the
322	ability of the applicant to carry out its responsibilities under
323	this part, authorizing statutes, and applicable rules.
324	(2)(a) The applicant for a renewal license must submit an
325	application that must be received by the agency at least 60 days
326	prior to the expiration of the current license. If the renewal
327	application and fee are received prior to the license expiration
328	date, the license shall not be deemed to have expired if the
329	license expiration date occurs during the agency's review of the
330	renewal application.
331	(b) The applicant for initial licensure due to a change of
332	ownership must submit an application that must be received by
333	the agency at least 60 days prior to the date of change of
334	ownership.
335	(c) For any other application or request, the applicant
336	must submit an application or request that must be received by
337	the agency at least 60 days prior to the requested effective
338	date, unless otherwise specified in authorizing statutes or
339	applicable rules.
340	(d) The agency shall notify the licensee by mail or
341	electronically at least 90 days prior to the expiration of a
342	license that a renewal license is necessary to continue
343	operation. The failure to timely submit an application and
344	license fee shall result in a late fee charged to the licensee
345	by the agency in an amount equal to 50 percent of the licensure
346	fee, but the aggregate amount of the fine may not exceed $5,000.
347	If an application is received after the required filing date and
348	exhibits a hand-canceled postmark obtained from a United States
349	post office dated on or before the required filing date, no fine
350	will be levied.
351	(3)(a) Upon receipt of an application for a license, the
352	agency shall examine the application and, within 30 days after
353	receipt, notify the applicant in writing of any apparent errors
354	or omissions and request any additional information required.
355	(b) Requested information omitted from an application for
356	licensure, license renewal, or change of ownership, other than
357	an inspection, must be filed with the agency within 21 days
358	after the agency's request for omitted information or the
359	application shall be deemed incomplete and shall be withdrawn
360	from further consideration and the fees shall be forfeited.
361	(c) Within 60 days after the receipt of a complete
362	application, the agency shall approve or deny the application.
363	(4)(a) Licensees subject to the provisions of this part
364	shall be issued biennial licenses unless conditions of the
365	license category specify a shorter license period.
366	(b) Each license issued shall indicate the name of the
367	licensee, the type of provider or service that the licensee is
368	required or authorized to operate or offer, the date the license
369	is effective, the expiration date of the license, the maximum
370	capacity of the licensed premises, if applicable, and any other
371	information required or deemed necessary by the agency.
372	(5) In accordance with authorizing statutes and applicable
373	rules, proof of compliance with s. 408.810 must be submitted
374	with an application for licensure.
375	(6) The agency may not issue an initial license to a
376	health care provider subject to the certificate-of-need
377	provisions in part I of this chapter if the licensee has not
378	been issued a certificate of need or certificate-of-need
379	exemption, when applicable. Failure to apply for the renewal of
380	a license prior to the expiration date renders the license void.
381	(7)(a) An applicant must demonstrate compliance with the
382	requirements in this part, authorizing statutes, and applicable
383	rules during an inspection pursuant to s. 408.811, as required
384	by authorizing statutes.
385	(b) An initial inspection is not required for companion
386	services or homemaker services providers, as provided under part
387	IV of chapter 400, or for health care services pools, as
388	provided under part XII of chapter 400.
389	(c) If an inspection is required by the authorizing
390	statute for a license application other than an initial
391	application, the inspection must be unannounced. This paragraph
392	does not apply to inspections required pursuant to ss. 383.324,
393	395.0161(4), and 483.061(2).
394	(d) If a provider is not available when an inspection is
395	attempted, the application shall be denied.
396	(8) The agency may establish procedures for the electronic
397	notification and submission of required information, including,
398	but not limited to:
399	(a) Licensure applications.
400	(b) Required signatures.
401	(c) Payment of fees.
402	(d) Notarization of applications.
403
404	Requirements for electronic submission of any documents required
405	by this part or authorizing statutes may be established by rule.
406	408.807 Change of ownership.--Whenever a change of
407	ownership occurs:
408	(1) The transferor shall notify the agency in writing at
409	least 60 days before the anticipated date of the change of
410	ownership.
411	(2) The transferee shall make application to the agency
412	for a license within the timeframes required in s. 408.806.
413	(3) The transferor shall be responsible and liable for:
414	(a) The lawful operation of the provider and the welfare
415	of the clients served until the date the transferee is licensed
416	by the agency.
417	(b) Any and all penalties imposed against the transferor
418	for violations occurring before the date of change of ownership.
419	(4) Any restriction on licensure, including a conditional
420	license existing at the time of a change of ownership, shall
421	remain in effect until the agency determines that the grounds
422	for the restriction are corrected.
423	(5) The transferee shall maintain records of the
424	transferor as required in this part, authorizing statutes, and
425	applicable rules, including:
426	(a) All client records.
427	(b) Inspection reports.
428	(c) All records required to be maintained pursuant to s.
429	409.913, if applicable.
430	408.808 License categories.--
431	(1) STANDARD LICENSE.--A standard license may be issued to
432	an applicant at the time of initial licensure, license renewal,
433	or change of ownership. A standard license shall be issued when
434	the applicant is in compliance with all statutory requirements
435	and agency rules. Unless sooner revoked, a standard license
436	expires 2 years after the date of issue.
437	(2) PROVISIONAL LICENSE.--A provisional license may be
438	issued to an applicant pursuant to s. 408.809(3). An applicant
439	against whom a proceeding denying or revoking a license is
440	pending at the time of license renewal may be issued a
441	provisional license effective until final action not subject to
442	further appeal.
443	(3) INACTIVE LICENSE.--An inactive license may be issued
444	to a health care provider subject to the certificate-of-need
445	provisions in part I of this chapter when the provider is
446	currently licensed, does not have a provisional license, and
447	will be temporarily unable to provide services but is reasonably
448	expected to resume services within 12 months. Such designation
449	may be made for a period not to exceed 12 months but may be
450	renewed by the agency for up to 12 additional months upon
451	demonstration by the licensee of the provider's progress toward
452	reopening. A request by a licensee for an inactive license or to
453	extend the previously approved inactive period must be submitted
454	to the agency and must include a written justification for the
455	inactive license with the beginning and ending dates of
456	inactivity specified, a plan for the transfer of any clients to
457	other providers, and the appropriate licensure fees. The agency
458	may not accept a request that is submitted after initiating
459	closure, after any suspension of service, or after notifying
460	clients of closure or suspension of service, unless the action
461	is a result of a natural or manmade disaster. Upon agency
462	approval, the provider shall notify clients of any necessary
463	discharge or transfer as required by authorizing statutes or
464	applicable rules. The beginning of the inactive license period
465	is the date the provider ceases operations. The end of the
466	inactive license period shall become the license expiration
467	date. All licensure fees must be current, must be paid in full,
468	and may be prorated. Reactivation of an inactive license
469	requires the approval of a renewal application, including
470	payment of licensure fees and agency inspections indicating
471	compliance with all requirements of this part, authorizing
472	statutes, and applicable rules.
473	(4) OTHER LICENSES.--Other types of license categories may
474	be issued pursuant to authorizing statutes or applicable rules.
475	408.809 Background screening; prohibited offenses.--
476	(1) Level 2 background screening pursuant to chapter 435
477	must be conducted through the agency on each of the following
478	persons, who shall be considered an employee for the purposes of
479	conducting screening under chapter 435:
480	(a) The licensee, if an individual.
481	(b) The administrator or a similarly titled person who is
482	responsible for the day-to-day operation of the provider.
483	(c) The financial officer or similarly titled individual
484	who is responsible for the financial operation of the licensee
485	or provider.
486	(d) Any person who is a controlling interest if the agency
487	has reason to believe that such person has been convicted of any
488	offense prohibited by s. 435.04. For each controlling interest
489	who has been convicted of any such offense, the licensee shall
490	submit to the agency a description and explanation of the
491	conviction at the time of license application.
492	(2) Proof of compliance with level 2 screening standards
493	submitted within the previous 5 years to meet any provider or
494	professional licensure requirements of the agency, the
495	Department of Health, the Agency for Persons with Disabilities,
496	or the Department of Children and Family Services satisfies the
497	requirements of this section, provided that such proof is
498	accompanied, under penalty of perjury, by an affidavit of
499	compliance with the provisions of chapter 435 using forms
500	provided by the agency. Proof of compliance with the background
501	screening requirements of the Department of Financial Services
502	submitted within the previous 5 years for an applicant for a
503	certificate of authority to operate a continuing care retirement
504	community under chapter 651 satisfies the Department of Law
505	Enforcement and Federal Bureau of Investigation portions of a
506	level 2 background check.
507	(3) A provisional license may be granted to an applicant
508	when each individual required by this section to undergo
509	background screening has met the standards for the Department of
510	Law Enforcement background check but the agency has not yet
511	received background screening results from the Federal Bureau of
512	Investigation. A standard license may be granted to the licensee
513	upon the agency's receipt of a report of the results of the
514	Federal Bureau of Investigation background screening for each
515	individual required by this section to undergo background
516	screening that confirms that all standards have been met or upon
517	the granting of an exemption from disqualification by the agency
518	as set forth in chapter 435.
519	(4) When a person is newly employed in a capacity that
520	requires screening under this section, the licensee must notify
521	the agency of the change within the time period specified in the
522	authorizing statute or rules and must submit to the agency
523	information necessary to conduct level 2 screening or provide
524	evidence of compliance with background screening requirements of
525	this section. The person may serve in his or her capacity
526	pending the agency's receipt of the report from the Federal
527	Bureau of Investigation if he or she has met the standards for
528	the Department of Law Enforcement background check. However, the
529	person may not continue to serve in his or her capacity if the
530	report indicates any violation of background screening standards
531	unless an exemption from disqualification has been granted by
532	the agency as set forth in chapter 435.
533	(5) Background screening is not required to obtain a
534	certificate of exemption issued under s. 483.106.
535	408.810 Minimum licensure requirements.--In addition to
536	the licensure requirements specified in this part, authorizing
537	statutes, and applicable rules, each applicant and licensee must
538	comply with the requirements of this section in order to obtain
539	and maintain a license.
540	(1) An applicant for licensure must comply with the
541	background screening requirements of s. 408.809.
542	(2) An applicant for licensure must provide a description
543	and explanation of any exclusions, suspensions, or terminations
544	of the applicant from the Medicare, Medicaid, or federal
545	Clinical Laboratory Improvement Amendment (CLIA) programs.
546	(3) Unless otherwise specified in this part, authorizing
547	statutes, or applicable rules, any information required to be
548	reported to the agency must be submitted within 21 calendar days
549	after the report period or effective date of the information.
550	(4) Whenever a licensee discontinues operation of a
551	provider:
552	(a) The licensee must inform the agency not less than 30
553	days prior to the discontinuance of operation and inform clients
554	of such discontinuance as required by authorizing statutes.
555	Immediately upon discontinuance of operation by a provider, the
556	licensee shall surrender the license to the agency and the
557	license shall be canceled.
558	(b) The licensee shall remain responsible for retaining
559	and appropriately distributing all records within the timeframes
560	prescribed in authorizing statutes and applicable rules. In
561	addition, the licensee or, in the event of death or dissolution
562	of a licensee, the estate or agent of the licensee shall:
563	1. Make arrangements to forward records for each client to
564	one of the following, based upon the client's choice: the client
565	or the client's legal representative, the client's attending
566	physician, or the health care provider where the client
567	currently receives services; or
568	2. Cause a notice to be published in the newspaper of
569	greatest general circulation in the county in which the provider
570	was located that advises clients of the discontinuance of the
571	provider operation. The notice must inform clients that they may
572	obtain copies of their records and specify the name, address,
573	and telephone number of the person from whom the copies of
574	records may be obtained. The notice must appear at least once a
575	week for 4 consecutive weeks.
576	(5)(a) On or before the first day services are provided to
577	a client, a licensee must inform the client and his or her
578	immediate family or representative, if appropriate, of the right
579	to report:
580	1. Complaints. The statewide toll-free telephone number
581	for reporting complaints to the agency must be provided to
582	clients in a manner that is clearly legible and must include the
583	words: "To report a complaint regarding the services you
584	receive, please call toll-free (phone number)."
585	2. Abusive, neglectful, or exploitative practices. The
586	statewide toll-free telephone number for the central abuse
587	hotline must be provided to clients in a manner that is clearly
588	legible and must include the words: "To report abuse, neglect,
589	or exploitation, please call toll-free (phone number)." The
590	agency shall publish a minimum of a 90-day advance notice of a
591	change in the toll-free telephone numbers.
592	(b) Each licensee shall establish appropriate policies and
593	procedures for providing such notice to clients.
594	(6) An applicant must provide the agency with proof of the
595	applicant's legal right to occupy the property before a license
596	may be issued. Proof may include, but need not be limited to,
597	copies of warranty deeds, lease or rental agreements, contracts
598	for deeds, quitclaim deeds, or other such documentation.
599	(7) If proof of insurance is required by the authorizing
600	statute, that insurance must be in compliance with chapter 624,
601	chapter 626, chapter 627, or chapter 628 and with agency rules.
602	(8) Upon application for initial licensure or change of
603	ownership licensure, the applicant shall furnish satisfactory
604	proof of the applicant's financial ability to operate in
605	accordance with the requirements of this part, authorizing
606	statutes, and applicable rules. The agency shall establish
607	standards for this purpose, including information concerning the
608	applicant's controlling interests. The agency shall also
609	establish documentation requirements, to be completed by each
610	applicant, that show anticipated provider revenues and
611	expenditures, the basis for financing the anticipated cash-flow
612	requirements of the provider, and an applicant's access to
613	contingency financing. A current certificate of authority,
614	pursuant to chapter 651, may be provided as proof of financial
615	ability to operate. The agency may require a licensee to provide
616	proof of financial ability to operate at any time if there is
617	evidence of financial instability, including, but not limited
618	to, unpaid expenses necessary for the basic operations of the
619	provider.
620	(9) A controlling interest may not withhold from the
621	agency any evidence of financial instability, including, but not
622	limited to, checks returned due to insufficient funds,
623	delinquent accounts, nonpayment of withholding taxes, unpaid
624	utility expenses, nonpayment for essential services, or adverse
625	court action concerning the financial viability of the provider
626	or any other provider licensed under this part that is under the
627	control of the controlling interest. Any person who violates
628	this subsection commits a misdemeanor of the second degree,
629	punishable as provided in s. 775.082 or s. 775.083. Each day of
630	continuing violation is a separate offense.
631	(10) The agency may not issue a license to a health care
632	provider subject to the certificate-of-need provisions in part I
633	of this chapter if the health care provider has not been issued
634	a certificate of need or an exemption. Upon initial licensure of
635	any such provider, the authorization contained in the
636	certificate of need shall be considered fully implemented and
637	merged into the license and shall have no force and effect upon
638	termination of the license for any reason.
639	408.811 Right of inspection; copies; inspection reports.--
640	(1) An authorized officer or employee of the agency may
641	make or cause to be made any inspection or investigation deemed
642	necessary by the agency to determine the state of compliance
643	with this part, authorizing statutes, and applicable rules. The
644	right of inspection extends to any business that the agency has
645	reason to believe is being operated as a provider without a
646	license, but inspection of any business suspected of being
647	operated without the appropriate license may not be made without
648	the permission of the owner or person in charge unless a warrant
649	is first obtained from a circuit court. Any application for a
650	license issued under this part, authorizing statutes, or
651	applicable rules constitutes permission for an appropriate
652	inspection to verify the information submitted on or in
653	connection with the application.
654	(a) All inspections shall be unannounced, except as
655	specified in s. 408.806.
656	(b) Inspections for relicensure shall be conducted
657	biennially unless otherwise specified by authorizing statutes or
658	applicable rules.
659	(2) Inspections conducted in conjunction with
660	certification may be accepted in lieu of a complete licensure
661	inspection. However, a licensure inspection may also be
662	conducted to review any licensure requirements that are not also
663	requirements for certification.
664	(3) The agency shall have access to and the licensee shall
665	provide copies of all provider records required during an
666	inspection at no cost to the agency.
667	(4)(a) Each licensee shall maintain as public information,
668	available upon request, records of all inspection reports
669	pertaining to that provider that have been filed by the agency
670	unless those reports are exempt from or contain information that
671	is exempt from s. 119.07(1) and s. 24(a), Art. I of the State
672	Constitution or is otherwise made confidential by law. Effective
673	October 1, 2006, copies of such reports shall be retained in the
674	records of the provider for at least 3 years following the date
675	the reports are filed and issued, regardless of a change of
676	ownership.
677	(b) A licensee shall, upon the request of any person who
678	has completed a written application with intent to be admitted
679	by such provider, any person who is a client of such provider,
680	or any relative, spouse, or guardian of any such person, furnish
681	to the requester a copy of the last inspection report pertaining
682	to the licensed provider that was issued by the agency or by an
683	accrediting organization if such report is used in lieu of a
684	licensure inspection.
685	408.812 Unlicensed activity.--
686	(1) A person or entity may not offer or advertise services
687	that require licensure as defined by this part, authorizing
688	statutes, or applicable rules to the public without obtaining a
689	valid license from the agency. A licenseholder may not advertise
690	or hold out to the public that he or she holds a license for
691	other than that for which he or she actually holds the license.
692	(2) The operation or maintenance of an unlicensed provider
693	or the performance of any services that require licensure
694	without proper licensure is a violation of this part and
695	authorizing statutes. Unlicensed activity constitutes harm that
696	materially affects the health, safety, and welfare of clients.
697	The agency or any state attorney may, in addition to other
698	remedies provided in this part, bring an action for an
699	injunction to restrain such violation, or to enjoin the future
700	operation or maintenance of the unlicensed provider or the
701	performance of any services in violation of this part and
702	authorizing statutes, until compliance with this part,
703	authorizing statutes, and agency rules has been demonstrated to
704	the satisfaction of the agency.
705	(3) It is unlawful for any person or entity to own,
706	operate, or maintain an unlicensed provider. If after receiving
707	notification from the agency, such person or entity fails to
708	cease operation and apply for a license under this part and
709	authorizing statutes, the person or entity shall be subject to
710	penalties as prescribed by authorizing statutes and applicable
711	rules. Each day of continued operation is a separate offense.
712	(4) Any person or entity that fails to cease operation
713	after agency notification may be fined $1,000 for each day of
714	noncompliance.
715	(5) When a controlling interest or licensee has an
716	interest in more than one provider and fails to license a
717	provider rendering services that require licensure, the agency
718	may revoke all licenses and impose actions under s. 408.814 and
719	a fine of $1,000 per day, unless otherwise specified by
720	authorizing statutes, against each licensee until such time as
721	the appropriate license is obtained for the unlicensed
722	operation.
723	(6) In addition to granting injunctive relief pursuant to
724	subsection (2), if the agency determines that a person or entity
725	is operating or maintaining a provider without obtaining a
726	license and determines that a condition exists that poses a
727	threat to the health, safety, or welfare of a client of the
728	provider, the person or entity is subject to the same actions
729	and fines imposed against a licensee as specified in this part,
730	authorizing statutes, and agency rules.
731	(7) Any person aware of the operation of an unlicensed
732	provider must report that provider to the agency.
733	408.813 Administrative fines.--As a penalty for any
734	violation of this part, authorizing statutes, or applicable
735	rules, the agency may impose an administrative fine. Unless the
736	amount or aggregate limitation of the fine is prescribed by
737	authorizing statutes or applicable rules, the agency may
738	establish criteria by rule for the amount or aggregate
739	limitation of administrative fines applicable to this part,
740	authorizing statutes, and applicable rules. Each day of
741	violation constitutes a separate violation and is subject to a
742	separate fine. For fines imposed by final order of the agency
743	and not subject to further appeal, the violator shall pay the
744	fine plus interest at the rate specified in s. 55.03 for each
745	day beyond the date set by the agency for payment of the fine.
746	408.814 Moratorium; emergency suspension.--
747	(1) The agency may impose an immediate moratorium or
748	emergency suspension as defined in s. 120.60 on any provider if
749	the agency determines that any condition related to the provider
750	or licensee presents a threat to the health, safety, or welfare
751	of a client.
752	(2) A provider or licensee, the license of which is denied
753	or revoked, may be subject to immediate imposition of a
754	moratorium or emergency suspension to run concurrently with
755	licensure denial, revocation, or injunction.
756	(3) A moratorium or emergency suspension remains in effect
757	after a change of ownership, unless the agency has determined
758	that the conditions that created the moratorium, emergency
759	suspension, or denial of licensure have been corrected.
760	(4) When a moratorium or emergency suspension is placed on
761	a provider or licensee, notice of the action shall be posted and
762	visible to the public at the location of the provider until the
763	action is lifted.
764	408.815 License or application denial; revocation.--
765	(1) In addition to the grounds provided in authorizing
766	statutes, grounds that may be used by the agency for denying and
767	revoking a license or change of ownership application include
768	any of the following actions by a controlling interest:
769	(a) False representation of a material fact in the license
770	application or omission of any material fact from the
771	application.
772	(b) An intentional or negligent act materially affecting
773	the health or safety of a client of the provider.
774	(c) A violation of this part, authorizing statutes, or
775	applicable rules.
776	(d) A demonstrated pattern of deficient performance.
777	(e) The applicant, licensee, or controlling interest has
778	been or is currently excluded, suspended, or terminated from
779	participation in the state Medicaid program, the Medicaid
780	program of any other state, or the Medicare program.
781	(2) If a licensee lawfully continues to operate while a
782	denial or revocation is pending in litigation, the licensee must
783	continue to meet all other requirements of this part,
784	authorizing statutes, and applicable rules and must file
785	subsequent renewal applications for licensure and pay all
786	licensure fees. The provisions of ss. 120.60(1) and
787	408.806(3)(c) shall not apply to renewal applications filed
788	during the time period in which the litigation of the denial or
789	revocation is pending until that litigation is final.
790	(3) An action under s. 408.814 or denial of the license of
791	the transferor may be grounds for denial of a change of
792	ownership application of the transferee.
793	408.816 Injunctions.--
794	(1) In addition to the other powers provided by this part,
795	authorizing statutes, and applicable rules, the agency may
796	institute injunction proceedings in a court of competent
797	jurisdiction to:
798	(a) Restrain or prevent the establishment or operation of
799	a provider that does not have a license or is in violation of
800	any provision of this part, authorizing statutes, or applicable
801	rules. The agency may also institute injunction proceedings in a
802	court of competent jurisdiction when a violation of this part,
803	authorizing statutes, or applicable rules constitutes an
804	emergency affecting the immediate health and safety of a client.
805	(b) Enforce the provisions of this part, authorizing
806	statutes, or any minimum standard, rule, or order issued or
807	entered into pursuant thereto when the attempt by the agency to
808	correct a violation through administrative sanctions has failed
809	or when the violation materially affects the health, safety, or
810	welfare of clients or involves any operation of an unlicensed
811	provider.
812	(c) Terminate the operation of a provider when a violation
813	of any provision of this part, authorizing statutes, or any
814	standard or rule adopted pursuant thereto exists that materially
815	affects the health, safety, or welfare of a client.
816
817	Such injunctive relief may be temporary or permanent.
818	(2) If action is necessary to protect clients of providers
819	from immediate, life-threatening situations, the court may allow
820	a temporary injunction without bond upon proper proofs being
821	made. If it appears by competent evidence or a sworn,
822	substantiated affidavit that a temporary injunction should be
823	issued, the court, pending the determination on final hearing,
824	shall enjoin the operation of the provider.
825	408.817 Administrative proceedings.--Administrative
826	proceedings challenging agency licensure enforcement action
827	shall be reviewed on the basis of the facts and conditions that
828	resulted in the agency action.
829	408.818 Health Care Trust Fund.--Unless otherwise
830	prescribed by authorizing statutes, all fees and fines collected
831	under this part, authorizing statutes, and applicable rules
832	shall be deposited into the Health Care Trust Fund, created in
833	s. 408.16, and used to pay the costs of the agency in
834	administering the provider program paying the fees or fines.
835	408.819 Rules.--The agency is authorized to adopt rules as
836	necessary to administer this part. Any licensed provider that is
837	in operation at the time of adoption of any applicable rule
838	under this part or authorizing statutes shall be given a
839	reasonable time under the particular circumstances, not to
840	exceed 6 months after the date of such adoption, within which to
841	comply with such rule, unless otherwise specified by rule.
842	408.820 Exemptions.--Except as prescribed in authorizing
843	statutes, the following exemptions shall apply to specified
844	requirements of this part:
845	(1) Laboratories authorized to perform testing under the
846	Drug-Free Workplace Act, as provided under ss. 112.0455 and
847	440.102, are exempt from s. 408.810(5)-(10).
848	(2) Birth centers, as provided under chapter 383, are
849	exempt from s. 408.810(7)-(10).
850	(3) Abortion clinics, as provided under chapter 390, are
851	exempt from s. 408.810(7)-(10).
852	(4) Crisis stabilization units, as provided under parts I
853	and IV of chapter 394, are exempt from s. 408.810(8)-(10).
854	(5) Short-term residential treatment facilities, as
855	provided under parts I and IV of chapter 394, are exempt from s.
856	408.810(8)-(10).
857	(6) Residential treatment facilities, as provided under
858	part IV of chapter 394, are exempt from s. 408.810(8)-(10).
859	(7) Residential treatment centers for children and
860	adolescents, as provided under part IV of chapter 394, are
861	exempt from s. 408.810(8)-(10).
862	(8) Hospitals, as provided under part I of chapter 395,
863	are exempt from s. 408.810(7)-(9).
864	(9) Ambulatory surgical centers, as provided under part I
865	of chapter 395, are exempt from s. 408.810(7)-(10).
866	(10) Mobile surgical facilities, as provided under part I
867	of chapter 395, are exempt from s. 408.810(7)-(10).
868	(11) Private review agents, as provided under part I of
869	chapter 395, are exempt from ss. 408.806(7), 408.810, and
870	408.811.
871	(12) Health care risk managers, as provided under part I
872	of chapter 395, are exempt from ss. 408.806(7), 408.810, and
873	408.811.
874	(13) Nursing homes, as provided under part II of chapter
875	400, are exempt from s. 408.810(7).
876	(14) Assisted living facilities, as provided under part
877	III of chapter 400, are exempt from s. 408.810(10).
878	(15) Home health agencies, as provided under part IV of
879	chapter 400, are exempt from s. 408.810(10).
880	(16) Nurse registries, as provided under part IV of
881	chapter 400, are exempt from s. 408.810(6) and (10).
882	(17) Companion services or homemaker services providers,
883	as provided under part IV of chapter 400, are exempt from s.
884	408.810(6)-(10).
885	(18) Adult day care centers, as provided under part V of
886	chapter 400, are exempt from s. 408.810(10).
887	(19) Adult family-care homes, as provided under part VII
888	of chapter 400, are exempt from s. 408.810(7)-(10).
889	(20) Homes for special services, as provided under part
890	VIII of chapter 400, are exempt from s. 408.810(7)-(10).
891	(21) Transitional living facilities, as provided under
892	part VIII of chapter 400, are exempt from s. 408.810(7)-(10).
893	(22) Prescribed pediatric extended care centers, as
894	provided under part IX of chapter 400, are exempt from s.
895	408.810(10).
896	(23) Home medical equipment providers, as provided under
897	part X of chapter 400, are exempt from s. 408.810(10).
898	(24) Intermediate care facilities for persons with
899	developmental disabilities, as provided under part XI of chapter
900	400, are exempt from s. 408.810(7).
901	(25) Health care services pools, as provided under part
902	XII of chapter 400, are exempt from s. 408.810(6)-(10).
903	(26) Health care clinics, as provided under part XIII of
904	chapter 400, are exempt from ss. 408.809 and 408.810(1), (6),
905	(7), and (10).
906	(27) Clinical laboratories, as provided under part I of
907	chapter 483, are exempt from s. 408.810(5)-(10).
908	(28) Multiphasic health testing centers, as provided under
909	part II of chapter 483, are exempt from s. 408.810(5)-(10).
910	(29) Organ and tissue procurement agencies, as provided
911	under chapter 765, are exempt from s. 408.810(5)-(10).
912	Section 6. Paragraph (b) of subsection (1) of section
913	400.801, Florida Statutes, is amended to read:
914	400.801 Homes for special services.--
915	(1) As used in this section, the term:
916	(b) "Home for special services" means a site licensed by
917	the agency prior to January 1, 2006, where specialized health
918	care services are provided, including personal and custodial
919	care, but not continuous nursing services.
920	Section 7. Subsections (1) and (3) of section 408.831,
921	Florida Statutes, are amended to read:
922	408.831 Denial, suspension, or revocation of a license,
923	registration, certificate, or application.--
924	(1) In addition to any other remedies provided by law, the
925	agency may deny each application or suspend or revoke each
926	license, registration, or certificate of entities regulated or
927	licensed by it:
928	(a) If the applicant, licensee, or a licensee subject to
929	this part which shares a common controlling interest with the
930	applicant ~~registrant, or certificateholder, or, in the case of a~~
931	~~corporation, partnership, or other business entity, if any~~
932	~~officer, director, agent, or managing employee of that business~~
933	~~entity or any affiliated person, partner, or shareholder having~~
934	~~an ownership interest equal to 5 percent or greater in that~~
935	~~business entity,~~ has failed to pay all outstanding fines, liens,
936	or overpayments assessed by final order of the agency or final
937	order of the Centers for Medicare and Medicaid Services, not
938	subject to further appeal, unless a repayment plan is approved
939	by the agency; or
940	(b) For failure to comply with any repayment plan.
941	(3) This section provides standards of enforcement
942	applicable to all entities licensed or regulated by the Agency
943	for Health Care Administration. This section controls over any
944	conflicting provisions of chapters 39, ~~381,~~ 383, 390, 391, ~~393,~~
945	394, 395, 400, 408, 468, 483, and 765 ~~641~~ or rules adopted
946	pursuant to those chapters.
947	Section 8. In case of conflict between the provisions of
948	part II of chapter 408, Florida Statutes, and the authorizing
949	statutes governing the licensure of health care providers by the
950	Agency for Health Care Administration found in s. 112.0455 and
951	chapters 383, 390, 394, 395, 400, 440, 483, and 765, Florida
952	Statutes, the provisions of part II of chapter 408, Florida
953	Statutes, shall prevail.
954	Section 9. All provisions that apply to the entities
955	specified in s. 408.802, Florida Statutes, as created by this
956	act, in effect on October 1, 2006, that provide for annual
957	licensure fees are hereby adjusted to provide for biennial
958	licensure fees with a corresponding doubling of the amount.
959	Section 10. The Legislature recognizes that there is a
960	need to conform the Florida Statutes to the policy decisions
961	reflected in this act and that there may be a need to resolve
962	apparent conflicts between any changes or additions to the
963	authorizing statutes, as defined in s. 408.803, Florida
964	Statutes, or any other legislation that has been or may be
965	enacted during 2006 and this chapter 408, Florida Statutes, as
966	amended by this act. Therefore, in the interim between this act
967	becoming a law and the 2007 Regular Session of the Legislature
968	or an earlier special session addressing this issue, the
969	Division of Statutory Revision shall provide the relevant
970	substantive committees of the Senate and the House of
971	Representatives with assistance, upon request, to enable such
972	committees to prepare draft legislation to conform the Florida
973	Statutes and any legislation enacted during 2006 to the
974	provisions of this act.
975	Section 11. For the purpose of staggering license
976	expiration dates, the Agency for Health Care Administration may
977	issue a license for less than a 2-year period to those providers
978	making the transition from annual to biennial licensure as
979	authorized in this act. The agency shall charge a prorated
980	licensure fee for this shortened period. This authority shall
981	expire September 30, 2008.
982	Section 12. This act shall take effect October 1, 2006.

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