Senate Bill sb0790c1

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    Florida Senate - 2006                            CS for SB 790

    By the Committee on Health Care





    587-1301-06

  1                      A bill to be entitled

  2         An act relating to certificates of need;

  3         transferring, renumbering, and amending s.

  4         651.1185, F.S.; extending the moratorium on

  5         certificates of need for additional community

  6         nursing home beds until July 1, 2011; providing

  7         an exception to the moratorium; amending s.

  8         408.040, F.S.; authorizing nursing homes in

  9         certain counties to request a reduction in

10         their annual Medicaid patient days; requiring

11         the Agency for Health Care Administration to

12         automatically grant such a request if the

13         nursing home meets certain conditions;

14         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

23  certificates of need.--

24         (1)  Notwithstanding the establishment of need as

25  provided for in this chapter 408, a no certificate of need for

26  additional community nursing home beds may not shall be

27  approved by the agency until July 1, 2011 2006.

28         (2)  The Legislature finds that the continued growth in

29  the Medicaid budget for nursing home care has constrained the

30  ability of the state to meet the needs of its elderly

31  residents through the use of less restrictive and less

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    Florida Senate - 2006                            CS for SB 790
    587-1301-06




 1  institutional methods of long-term care. It is therefore the

 2  intent of the Legislature to limit the increase in Medicaid

 3  nursing home expenditures in order to provide funds to invest

 4  in long-term care that is community-based and provides

 5  supportive services in a manner that is both more

 6  cost-effective and more in keeping with the wishes of the

 7  elderly residents of this state.

 8         (3)  This moratorium on certificates of need shall not

 9  apply to sheltered nursing home beds in a continuing care

10  retirement community certified by the former Department of

11  Insurance or by the Office of Insurance Regulation pursuant to

12  chapter 651.

13         (4)(a)  The moratorium on certificates of need does not

14  apply and a certificate of need for additional community

15  nursing home beds may be approved for a county that meets the

16  following circumstances:

17         1.  The county has no community nursing home beds; and

18         2.  The lack of community nursing home beds occurs

19  because all nursing home beds in the county that were licensed

20  on July 1, 2001, have subsequently closed.

21         (b)  The certificate-of-need review for such

22  circumstances shall be subject to the comparative review

23  process consistent with the provisions of s. 408.039, and the

24  number of beds may not exceed the number of beds lost by the

25  county after July 1, 2001.

26  

27  This subsection shall be repealed upon the expiration of the

28  moratorium established in subsection (1).

29         (5)  The moratorium on certificates of need does not

30  apply for the addition of nursing home beds licensed under

31  chapter 400 to a nursing home located in a county having up to

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    Florida Senate - 2006                            CS for SB 790
    587-1301-06




 1  50,000 residents, in a number not exceeding 10 total beds or

 2  10 percent of the number of beds licensed in the facility

 3  being expanded, whichever is greater. In addition to any other

 4  documentation required by the agency, a request submitted

 5  under this subsection must:

 6         (a)  Certify that the facility has not had any class I

 7  or class II deficiencies within the 30 months preceding the

 8  request for addition.

 9         (b)  Certify that the prior 12-month average occupancy

10  rate for the nursing home beds at the facility meets or

11  exceeds 94 percent and the facility had not had any class I or

12  class II deficiencies since its initial licensure.

13         (c)  For a facility that has been licensed for less

14  than 24 months, certify that the prior 6-month average

15  occupancy rate for the nursing home beds at the facility meets

16  or exceeds 94 percent and that the facility has not had any

17  class I or class II deficiencies since its initial licensure.

18  

19  This subsection shall be repealed upon the expiration of the

20  moratorium established in subsection (1).

21         (6)  The moratorium on certificates of need does not

22  apply for the addition of nursing home beds licensed under

23  chapter 400 in a number not exceeding 10 total beds or 10

24  percent of the number of beds licensed in the facility being

25  expanded, whichever is greater, if the facility meets the

26  requirements of paragraph (a).

27         (a)  In addition to any other documentation required by

28  the agency, a request for the addition of beds under this

29  subsection must certify that:

30  

31  

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    Florida Senate - 2006                            CS for SB 790
    587-1301-06




 1         1.  The facility has not had any class I or class II

 2  deficiencies within the 30 months preceding the request for

 3  addition;

 4         2.  The prior 12-month average occupancy rate for the

 5  nursing home beds at the facility meets or exceeds 96 percent;

 6         3.  The occupancy rate for nursing home beds in the

 7  subdistrict is 94 percent or greater; and

 8         4.  Any beds authorized for the facility under this

 9  subsection before the date of the current request for

10  additional beds have been licensed and operational for at

11  least 12 months.

12         (b)  A nursing home may request additional beds under

13  this subsection as an exemption from the provisions of s.

14  408.036(1). The timeframes and monitoring process specified in

15  s. 408.040(2)(a)-(c) apply to any exemption issued under this

16  subsection.

17         (c)  The agency shall count beds authorized under this

18  subsection as approved beds in the published inventory of

19  nursing home beds until the beds are licensed.

20  

21  This subsection shall be repealed upon the expiration of the

22  moratorium established in subsection (1).

23         Section 2.  Subsection (1) of section 408.040, Florida

24  Statutes, is amended to read:

25         408.040  Conditions and monitoring.--

26         (1)(a)  The agency may issue a certificate of need, or

27  an exemption, predicated upon statements of intent expressed

28  by an applicant in the application for a certificate of need

29  or an exemption. Any conditions imposed on a certificate of

30  need or an exemption based on such statements of intent shall

31  

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    Florida Senate - 2006                            CS for SB 790
    587-1301-06




 1  be stated on the face of the certificate of need or in the

 2  exemption approval.

 3         (b)  The agency may consider, in addition to the other

 4  criteria specified in s. 408.035, a statement of intent by the

 5  applicant that a specified percentage of the annual patient

 6  days at the facility will be utilized by patients eligible for

 7  care under Title XIX of the Social Security Act. Any

 8  certificate of need issued to a nursing home in reliance upon

 9  an applicant's statements that a specified percentage of

10  annual patient days will be utilized by residents eligible for

11  care under Title XIX of the Social Security Act must include a

12  statement that such certification is a condition of issuance

13  of the certificate of need. The certificate-of-need program

14  shall notify the Medicaid program office and the Department of

15  Elderly Affairs when it imposes conditions as authorized in

16  this paragraph in an area in which a community diversion pilot

17  project is implemented.

18         (c)  A certificateholder or an exemption holder may

19  apply to the agency for a modification of conditions imposed

20  under paragraph (a) or paragraph (b). If the holder of a

21  certificate of need or an exemption demonstrates good cause

22  why the certificate or exemption should be modified, the

23  agency shall reissue the certificate of need or exemption with

24  such modifications as may be appropriate. The agency shall by

25  rule define the factors constituting good cause for

26  modification.

27         (d)  If a nursing home is located in a county where a

28  long-term care community diversion pilot project has been

29  implemented under s. 430.705 or in a county where an

30  integrated, fixed-payment delivery system for Medicaid

31  recipients who are 60 years of age or older has been

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    Florida Senate - 2006                            CS for SB 790
    587-1301-06




 1  implemented under s. 409.912(5), the nursing home may request

 2  a reduction in the percentage of annual patient days utilized

 3  by residents who are eligible for care under Title XIX of the

 4  Social Security Act, which is a condition of the nursing

 5  home's certificate of need. The agency shall automatically

 6  grant the nursing home's request if the reduction is not more

 7  than 15 percent of the nursing home's annual

 8  Medicaid-patient-days condition. A nursing home may submit

 9  only one request every 2 years for an automatic reduction. A

10  requesting nursing home must notify the agency in writing at

11  least 60 days in advance of its intent to reduce its annual

12  Medicaid-patient-days condition by not more than 15 percent.

13  The agency must acknowledge the request in writing and must

14  change its records to reflect the revised certificate-of-need

15  condition. This paragraph expires June 30, 2011.

16         (e)(d)  If the holder of a certificate of need or an

17  exemption fails to comply with a condition upon which the

18  issuance of the certificate or exemption was predicated, the

19  agency may assess an administrative fine against the

20  certificateholder or exemption holder in an amount not to

21  exceed $1,000 per failure per day. Failure to annually report

22  compliance with any condition upon which the issuance of the

23  certificate or exemption was predicated constitutes

24  noncompliance. In assessing the penalty, the agency shall take

25  into account as mitigation the degree of noncompliance.

26  Proceeds of such penalties shall be deposited in the Public

27  Medical Assistance Trust Fund.

28         Section 3.  This act shall take effect upon becoming a

29  law.

30  

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    Florida Senate - 2006                            CS for SB 790
    587-1301-06




 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                         Senate Bill 790

 3                                 

 4  The committee substitute authorizes nursing homes in certain
    counties to request up to a 15 percent reduction in their
 5  annual Medicaid patient-days certificate-of-need conditions.
    If the nursing homes meet certain conditions, then the Agency
 6  for Health Care Administration must automatically grant such
    requests. The bill provides for a future repeal of this
 7  provision. The bill clarifies that a nursing home can apply
    for additional beds under the bill as a CON exemption.
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