Senate Bill sb7006pb
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Florida Senate - 2007 (PROPOSED COMMITTEE BILL) SPB 7006
FOR CONSIDERATION By the Committee on Health Regulation
587-371C-07
1 A bill to be entitled
2 An act conforming the Florida Statutes to
3 legislation enacted during the 2006 Regular
4 Session relating to the licensure of health
5 care providers regulated by the Agency for
6 Health Care Administration; amending s.
7 112.0455, F.S.; providing applicability of
8 licensure requirements under pt. II of ch. 408,
9 F.S., to drug-testing standards of
10 laboratories; authorizing the Agency for Health
11 Care Administration to adopt rules to implement
12 pt. II of ch. 408, F.S., relating to the
13 Drug-Free Workplace Act; revising a license
14 fee; amending s. 381.78, F.S.; conforming a
15 cross-reference; amending s. 383.301, F.S.;
16 providing applicability of licensure
17 requirements under pt. II of ch. 408, F.S., to
18 birth centers; repealing s. 383.304, F.S.,
19 relating to the licensure requirement for birth
20 centers; amending s. 383.305, F.S.; providing
21 applicability of licensure requirements under
22 pt. II of ch. 408, F.S., to birth centers;
23 providing for licensure fees to be established
24 by rule; amending s. 383.309, F.S.; authorizing
25 the agency to adopt and enforce rules to
26 administer pt. II of ch. 408, F.S., relating to
27 standards for birth centers; amending s.
28 383.315, F.S.; revising a provision relating to
29 consultation agreements for birth centers;
30 amending s. 383.324, F.S.; revising provisions
31 relating to inspections and investigations of
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Florida Senate - 2007 (PROPOSED COMMITTEE BILL) SPB 7006
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1 birth center facilities; repealing s. 383.325,
2 F.S., relating to inspection reports of birth
3 centers; amending s. 383.33, F.S.; revising
4 provisions relating to administrative fines,
5 penalties, emergency orders, and moratoriums on
6 admissions; repealing s. 383.331, F.S.,
7 relating to injunctive relief; amending s.
8 383.332, F.S.; providing applicability of
9 licensure requirements under pt. II of ch. 408,
10 F.S.; amending s. 383.335, F.S.; providing an
11 exemption from pt. II of ch. 408, F.S., for
12 specified birth centers; amending s. 383.50,
13 F.S.; conforming a cross-reference; amending s.
14 390.011, F.S.; revising a definition; amending
15 s. 390.012, F.S.; revising rulemaking authority
16 of the agency for abortion clinics; repealing
17 s. 390.013, F.S., relating to effective date of
18 rules applicable to abortion clinics; amending
19 s. 390.014, F.S.; providing applicability of
20 licensure requirements under pt. II of ch. 408,
21 F.S., to abortion clinics; amending s. 390.015,
22 F.S.; revising provisions to applications for a
23 license; repealing s. 390.016, F.S., relating
24 to expiration and renewal of a license;
25 repealing s. 390.017, F.S., relating to grounds
26 for suspension or revocation of a license;
27 amending s. 390.018, F.S.; providing
28 applicability of licensure requirements under
29 pt. II of ch. 408, F.S., to administrative
30 fines; repealing s. 390.019, F.S., relating an
31 to administrative penalty in lieu of revocation
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1 or suspension of a license to operate an
2 abortion clinic; repealing s. 390.021, F.S.,
3 relating to instituting injunction proceedings
4 against an abortion clinic; amending s.
5 394.455, F.S.; revising a definition; amending
6 s. 394.4787, F.S.; conforming a
7 cross-reference; amending s. 394.67, F.S.;
8 deleting, revising, and providing definitions;
9 amending ss. 394.74 and 394.82, F.S.;
10 conforming cross-references; amending s.
11 394.875, F.S.; providing the purpose of
12 short-term residential treatment facilities;
13 providing applicability of licensure
14 requirements under pt. II of ch. 408, F.S., to
15 crisis stabilization units, short-term
16 residential treatment facilities, residential
17 treatment facilities, and residential treatment
18 centers for children and adolescents; providing
19 an exemption from licensure requirements for
20 hospitals licensed under ch. 395, F.S., and
21 certain programs operated therein; amending s.
22 394.876, F.S.; revising provisions relating to
23 an application for licensure to provide
24 community substance abuse and mental health
25 services; amending s. 394.877, F.S.; providing
26 applicability of pt. II of ch. 408, F.S., to
27 license fees; repealing s. 394.878, F.S.,
28 relating to issuance and renewal of licenses;
29 amending s. 394.879, F.S.; providing rulemaking
30 authority to the Department of Children and
31 Family Services; deleting a reference to
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1 deposit of certain fines in the Mental Health
2 Facility Trust Fund; amending s. 394.90, F.S.;
3 revising provisions relating to inspections of
4 crisis stabilization units and residential
5 treatment facilities; amending s. 394.902,
6 F.S.; revising provisions relating to the
7 moratorium on admissions for unsafe or unlawful
8 provision of community substance abuse and
9 mental health services; amending s. 394.907,
10 F.S., relating to access to records of
11 community mental health centers; providing for
12 the department to determine licensee compliance
13 with quality assurance programs; amending s.
14 395.002, F.S.; deleting a definition;
15 conforming cross-references; amending ss.
16 395.003, 395.004, and 395.0161, F.S.; providing
17 applicability of licensure requirements under
18 pt. II of ch. 408, F.S., to hospitals,
19 ambulatory surgical centers, and mobile
20 surgical facilities; repealing s. 395.0055,
21 F.S., relating to background screening of
22 personnel of hospitals and other licensed
23 facilities; repealing s. 395.0162, F.S.,
24 relating to inspection reports of hospitals and
25 other licensed facilities; amending s.
26 395.0163, F.S.; deleting a provision requiring
27 the deposit of fees charged for review of plans
28 for construction of hospitals and other
29 licensed facilities in the Planning and
30 Regulation Trust Fund; amending ss. 395.0193
31 and 395.0197, F.S.; providing for the
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1 applicability of the reporting requirements of
2 pt. II of ch. 408, F.S., to hospitals and other
3 licensed facilities; conforming
4 cross-references; amending ss. 395.0199 and
5 395.1046, F.S.; providing applicability of
6 licensure requirements under pt. II of ch. 408,
7 F.S., to health care utilization review and
8 complaint investigation procedures; amending s.
9 395.1055, F.S.; providing applicability of
10 licensure requirements under pt. II of ch. 408,
11 F.S., to the adoption and enforcement of rules;
12 amending ss. 395.1065, 395.10973, and
13 395.10974, F.S.; providing applicability of
14 licensure requirements under pt. II of ch. 408,
15 F.S., to administrative penalties and
16 injunctions, rulemaking, and health care risk
17 managers; amending ss. 395.602, 395.701,
18 400.0073, and 400.0074, F.S.; conforming
19 cross-references; amending s. 400.021, F.S.;
20 deleting definitions; amending s. 400.022,
21 F.S.; providing applicability of licensure
22 requirements under pt. II of ch. 408, F.S., to
23 grounds for action for a violation of
24 residents' rights; amending s. 400.051, F.S.;
25 conforming a cross-reference; amending s.
26 400.062, F.S.; providing applicability of
27 licensure requirements under pt. II of ch. 408,
28 F.S., to nursing homes and related health care
29 facilities; revising provisions relating to
30 license fees; amending s. 400.063, F.S.;
31 conforming a cross-reference; amending ss.
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1 400.071 and 400.0712, F.S.; providing
2 applicability of licensure requirements under
3 pt. II of ch. 408, F.S., to license
4 applications; revising provisions governing
5 inactive licenses; amending s. 400.102, F.S.;
6 providing applicability of licensure
7 requirements under pt. II of ch. 408, F.S., to
8 grounds for action by the agency against a
9 licensee; amending s. 400.111, F.S.; providing
10 applicability of licensure requirements under
11 pt. II of ch. 408, F.S., to the disclosure of a
12 controlling interest of a nursing home
13 facility; requiring a licensee to disclose
14 certain holdings of a controlling interest;
15 amending s. 400.1183, F.S.; revising grievance
16 procedures for nursing home residents; deleting
17 a provision relating to an administrative fine;
18 amending s. 400.121, F.S.; providing
19 applicability of licensure requirements under
20 pt. II of ch. 408, F.S., to the denial,
21 suspension, or revocation of a nursing home
22 facility license, fines imposed, and procedures
23 for conducting hearings; repealing s. 400.125,
24 F.S., relating to instituting injunction
25 proceedings against a nursing home; amending s.
26 400.141, F.S.; conforming a cross-reference;
27 amending s. 400.179, F.S.; revising provisions
28 relating to liability for Medicaid
29 underpayments and overpayments; requiring that
30 certain licensure fees be paid annually;
31 amending s. 400.18, F.S.; revising provisions
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1 relating to the closing of a nursing home
2 facility; amending s. 400.19, F.S.; providing
3 applicability of licensure requirements under
4 pt. II of ch. 408, F.S., to nursing home
5 facility inspections; amending s. 400.191,
6 F.S.; revising provisions relating to the
7 availability, distribution, and posting of
8 reports and records; amending s. 400.23, F.S.;
9 providing applicability of pt. II of ch. 408,
10 F.S., to rulemaking for nursing home
11 facilities; amending s. 400.241, F.S.; deleting
12 provisions relating to prohibited acts
13 involving the establishment, operation, or
14 advertisement of nursing home facilities;
15 amending ss. 400.464, 400.471, 400.474, and
16 400.484, F.S.; providing applicability of
17 licensure requirements under pt. II of ch. 408,
18 F.S., to home health agencies; repealing s.
19 400.495, F.S., relating to the notice of a
20 toll-free telephone number for the central
21 abuse hotline; amending ss. 400.497, 400.506,
22 400.509, 400.602, 400.605, 400.606, 400.6065,
23 400.607, 400.801, 400.805, 400.903, 400.905,
24 400.907, 400.908, 400.912, 400.914, and
25 400.915, F.S.; providing applicability of
26 licensure requirements under pt. II of ch. 408,
27 F.S., to the toll-free central abuse hotline,
28 rules establishing minimum standards for home
29 health aides, nurse registries, the
30 registration of companion or homemaker service
31 providers that are exempt from licensure,
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1 hospices, homes for special services,
2 transitional living facilities, and prescribed
3 pediatric extended care (PPEC) centers;
4 amending s. 400.512, F.S.; revising provisions
5 relating to the screening of home health
6 agency, nurse registry, companion, and
7 homemaker personnel; repealing s. 400.515,
8 F.S., relating to instituting injunction
9 proceedings against a home health agency or
10 nurse registry; amending s. 400.6095, F.S.;
11 clarifying provisions relating to protection
12 from liability for hospice staff; amending s.
13 400.902, F.S.; revising a definition; amending
14 s. 400.906, F.S.; revising provisions relating
15 to applications for a license to operate a PPEC
16 center; repealing s. 400.910, F.S., relating to
17 expiration and renewal of a license and the
18 issuance of a conditional license or permit to
19 operate a PPEC center; repealing s. 400.911,
20 F.S., relating to instituting injunction
21 proceedings against a PPEC center; repealing s.
22 400.913, F.S., relating to right to enter and
23 inspect a PPEC center; amending s. 400.916,
24 F.S.; revising provisions relating to
25 prohibited acts and penalties applicable to a
26 PPEC center; repealing s. 400.917, F.S.,
27 relating to disposition of moneys from fines
28 and fees imposed on a PPEC center; amending s.
29 400.925, F.S.; deleting and revising
30 definitions; amending ss. 400.93, 400.931,
31 400.932, 400.933, 400.935, 400.953, and
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1 400.955, F.S.; providing applicability of
2 licensure requirements under pt. II of ch. 408,
3 F.S., to home medical equipment providers;
4 repealing s. 400.95, F.S., relating to notice
5 of the toll-free telephone number for the
6 central abuse hotline; repealing s. 400.956,
7 F.S., relating to instituting injunction
8 proceedings against a home medical equipment
9 provider; amending ss. 400.962, 400.967,
10 400.968, and 400.969, F.S.; providing
11 applicability of licensure requirements under
12 pt. II of ch. 408, F.S., to intermediate care
13 facilities for developmentally disabled
14 persons; repealing s. 400.963, F.S., relating
15 to instituting injunction proceedings against
16 an intermediate care facility for
17 developmentally disabled persons; repealing s.
18 400.965, F.S., relating to agency action
19 against an intermediate care facility for
20 developmentally disabled persons; amending s.
21 400.980, F.S.; providing applicability of
22 licensure requirements under pt. II of ch. 408,
23 F.S., to health care services pools; amending
24 ss. 400.991, 400.9915, 400.9925, 400.993,
25 400.9935, and 400.995, F.S.; providing
26 applicability of licensure requirements under
27 pt. II of ch. 408, F.S., to health care
28 clinics; repealing s. 400.992, F.S., relating
29 to license renewal, transfer of ownership, and
30 provisional license of a health care clinic;
31 repealing s. 400.994, F.S., relating to
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1 instituting injunctive proceedings against a
2 health care clinic; repealing s. 400.9945,
3 F.S., relating to review of agency licensure
4 enforcement actions; amending ss. 408.802 and
5 408.832, F.S.; revising provisions to conform
6 to changes made by the act; amending ss.
7 409.221, 409.815, 409.905, and 409.907, F.S.;
8 conforming cross-references; amending ss.
9 429.02, 429.07, 429.075, 429.08, 429.11,
10 429.12, 429.14, 429.17, 429.174, 429.176,
11 429.18, 429.19, 429.22, 429.26, 429.31, 429.34,
12 429.35, 429.41, and 429.47, F.S.; providing
13 applicability of licensure requirements under
14 pt. II of ch. 408, F.S., to assisted living
15 facilities; repealing s. 429.15, F.S., relating
16 to imposing a moratorium on admissions to an
17 assisted living facility and notice thereof;
18 repealing s. 429.21, F.S., relating to
19 instituting injunctive proceedings against an
20 assisted living facility; repealing s. 429.51,
21 F.S., relating to the time for an existing
22 assisted living facility to comply with newly
23 adopted rules and standards; amending ss.
24 429.67, 429.69, 429.71, and 429.73, F.S.;
25 providing applicability of licensure
26 requirements under pt. II of ch. 408, F.S., to
27 adult family-care homes; repealing s. 429.77,
28 F.S., relating to instituting injunctive
29 proceedings against an adult family-care home;
30 amending ss. 429.901, 429.907, 429.909,
31 429.911, 429.913, 429.915, 429.919, 429.925,
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1 429.927, and 429.929, F.S.; providing
2 applicability of licensure requirements under
3 pt. II of ch. 408, F.S., to adult day care
4 centers; repealing s. 429.921, F.S., relating
5 to the disposition of fees and administrative
6 fines imposed on adult day care centers;
7 repealing s. 429.923, F.S., relating to
8 instituting injunctive proceedings against an
9 adult day care center; repealing s. 429.933,
10 F.S., relating to prohibited acts and penalties
11 applicable to adult day care centers; amending
12 s. 440.102, F.S.; providing applicability of
13 licensure requirements under pt. II of ch. 408,
14 F.S., to drug-testing laboratories; amending
15 ss. 468.505 and 483.106, F.S.; conforming
16 cross-references; amending ss. 483.035,
17 483.051, 483.061, 483.091, 483.101, 483.111,
18 483.172, 483.201, and 483.221, F.S.; providing
19 applicability of licensure requirements under
20 pt. II of ch. 408, F.S., to certain clinical
21 laboratories; repealing s. 483.131, F.S.,
22 relating to display of the clinical laboratory
23 license; repealing s. 483.25, F.S., relating to
24 instituting injunctive proceedings against a
25 clinical laboratory; amending ss. 483.291,
26 483.294, 483.30, 483.302, 483.317, 483.32, and
27 483.322, F.S.; providing applicability of
28 licensure requirements under pt. II of ch. 408,
29 F.S., to multiphasic health testing centers;
30 repealing s. 483.311, F.S., relating to the
31 display of a multiphasic health testing center
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1 license; amending s. 483.317, F.S.; repealing
2 s. 483.328, F.S., relating to instituting
3 injunctive proceedings against a multiphasic
4 health testing center; amending s. 765.541,
5 F.S.; conforming provisions relating to
6 cadaveric organ and tissue procurement;
7 amending s. 765.542, F.S.; providing
8 applicability of licensure requirements under
9 pt. II of ch. 408, F.S., to organ procurement
10 organizations and tissue and eye banks;
11 amending s. 765.544, F.S.; conforming
12 provisions relating to application fees from
13 organizations and tissue and eye banks;
14 amending ss. 766.118, 766.316, and 812.014,
15 F.S.; conforming cross-references; providing an
16 effective date.
17
18 Be It Enacted by the Legislature of the State of Florida:
19
20 Section 1. Subsections (12) and (17) and paragraph (a)
21 of subsection (13) of section 112.0455, Florida Statutes, are
22 amended to read:
23 112.0455 Drug-Free Workplace Act.--
24 (12) DRUG-TESTING STANDARDS; LABORATORIES.--
25 (a) The requirements of part II of chapter 408 apply
26 to the provision of services that require licensure pursuant
27 to this section and part II of chapter 408 and to entities
28 licensed by or applying for such licensure from the Agency for
29 Health Care Administration pursuant to this section. A license
30 issued by the agency is required in order to operate a
31 laboratory.
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1 (b)(a) A laboratory may analyze initial or
2 confirmation drug specimens only if:
3 1. The laboratory is licensed and approved by the
4 Agency for Health Care Administration using criteria
5 established by the United States Department of Health and
6 Human Services as general guidelines for modeling the state
7 drug testing program and in accordance with part II of chapter
8 408. Each applicant for licensure and licensee must comply
9 with all requirements of part II of chapter 408. the following
10 requirements:
11 a. Upon receipt of a completed, signed, and dated
12 application, the agency shall require background screening, in
13 accordance with the level 2 standards for screening set forth
14 in chapter 435, of the managing employee, or other similarly
15 titled individual responsible for the daily operation of the
16 laboratory, and of the financial officer, or other similarly
17 titled individual who is responsible for the financial
18 operation of the laboratory, including billings for services.
19 The applicant must comply with the procedures for level 2
20 background screening as set forth in chapter 435, as well as
21 the requirements of s. 435.03(3).
22 b. The agency may require background screening of any
23 other individual who is an applicant if the agency has
24 probable cause to believe that he or she has been convicted of
25 an offense prohibited under the level 2 standards for
26 screening set forth in chapter 435.
27 c. Proof of compliance with the level 2 background
28 screening requirements of chapter 435 which has been submitted
29 within the previous 5 years in compliance with any other
30 health care licensure requirements of this state is acceptable
31 in fulfillment of screening requirements.
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1 d. A provisional license may be granted to an
2 applicant when each individual required by this section to
3 undergo background screening has met the standards for the
4 Department of Law Enforcement background check, but the agency
5 has not yet received background screening results from the
6 Federal Bureau of Investigation, or a request for a
7 disqualification exemption has been submitted to the agency as
8 set forth in chapter 435, but a response has not yet been
9 issued. A license may be granted to the applicant upon the
10 agency's receipt of a report of the results of the Federal
11 Bureau of Investigation background screening for each
12 individual required by this section to undergo background
13 screening which confirms that all standards have been met, or
14 upon the granting of a disqualification exemption by the
15 agency as set forth in chapter 435. Any other person who is
16 required to undergo level 2 background screening may serve in
17 his or her capacity pending the agency's receipt of the report
18 from the Federal Bureau of Investigation. However, the person
19 may not continue to serve if the report indicates any
20 violation of background screening standards and a
21 disqualification exemption has not been requested of and
22 granted by the agency as set forth in chapter 435.
23 e. Each applicant must submit to the agency, with its
24 application, a description and explanation of any exclusions,
25 permanent suspensions, or terminations of the applicant from
26 the Medicare or Medicaid programs. Proof of compliance with
27 the requirements for disclosure of ownership and control
28 interests under the Medicaid or Medicare programs shall be
29 accepted in lieu of this submission.
30 f. Each applicant must submit to the agency a
31 description and explanation of any conviction of an offense
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1 prohibited under the level 2 standards of chapter 435 by a
2 member of the board of directors of the applicant, its
3 officers, or any individual owning 5 percent or more of the
4 applicant. This requirement does not apply to a director of a
5 not-for-profit corporation or organization if the director
6 serves solely in a voluntary capacity for the corporation or
7 organization, does not regularly take part in the day-to-day
8 operational decisions of the corporation or organization,
9 receives no remuneration for his or her services on the
10 corporation or organization's board of directors, and has no
11 financial interest and has no family members with a financial
12 interest in the corporation or organization, provided that the
13 director and the not-for-profit corporation or organization
14 include in the application a statement affirming that the
15 director's relationship to the corporation satisfies the
16 requirements of this sub-subparagraph.
17 g. A license may not be granted to any applicant if
18 the applicant or managing employee has been found guilty of,
19 regardless of adjudication, or has entered a plea of nolo
20 contendere or guilty to, any offense prohibited under the
21 level 2 standards for screening set forth in chapter 435,
22 unless an exemption from disqualification has been granted by
23 the agency as set forth in chapter 435.
24 h. The agency may deny or revoke licensure if the
25 applicant:
26 (I) Has falsely represented a material fact in the
27 application required by sub-subparagraph e. or
28 sub-subparagraph f., or has omitted any material fact from the
29 application required by sub-subparagraph e. or
30 sub-subparagraph f.; or
31
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1 (II) Has had prior action taken against the applicant
2 under the Medicaid or Medicare program as set forth in
3 sub-subparagraph e.
4 i. An application for license renewal must contain the
5 information required under sub-subparagraphs e. and f.
6 2. The laboratory has written procedures to ensure
7 chain of custody.
8 3. The laboratory follows proper quality control
9 procedures, including, but not limited to:
10 a. The use of internal quality controls including the
11 use of samples of known concentrations which are used to check
12 the performance and calibration of testing equipment, and
13 periodic use of blind samples for overall accuracy.
14 b. An internal review and certification process for
15 drug test results, conducted by a person qualified to perform
16 that function in the testing laboratory.
17 c. Security measures implemented by the testing
18 laboratory to preclude adulteration of specimens and drug test
19 results.
20 d. Other necessary and proper actions taken to ensure
21 reliable and accurate drug test results.
22 (c)(b) A laboratory shall disclose to the employer a
23 written test result report within 7 working days after receipt
24 of the sample. All laboratory reports of a drug test result
25 shall, at a minimum, state:
26 1. The name and address of the laboratory which
27 performed the test and the positive identification of the
28 person tested.
29 2. Positive results on confirmation tests only, or
30 negative results, as applicable.
31
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1 3. A list of the drugs for which the drug analyses
2 were conducted.
3 4. The type of tests conducted for both initial and
4 confirmation tests and the minimum cutoff levels of the tests.
5 5. Any correlation between medication reported by the
6 employee or job applicant pursuant to subparagraph (8)(b)2.
7 and a positive confirmed drug test result.
8
9 No report shall disclose the presence or absence of any drug
10 other than a specific drug and its metabolites listed pursuant
11 to this section.
12 (d)(c) The laboratory shall submit to the Agency for
13 Health Care Administration a monthly report with statistical
14 information regarding the testing of employees and job
15 applicants. The reports shall include information on the
16 methods of analyses conducted, the drugs tested for, the
17 number of positive and negative results for both initial and
18 confirmation tests, and any other information deemed
19 appropriate by the Agency for Health Care Administration. No
20 monthly report shall identify specific employees or job
21 applicants.
22 (e)(d) Laboratories shall provide technical assistance
23 to the employer, employee, or job applicant for the purpose of
24 interpreting any positive confirmed test results which could
25 have been caused by prescription or nonprescription medication
26 taken by the employee or job applicant.
27 (13) RULES.--
28 (a) The Agency for Health Care Administration may
29 adopt additional rules to support this law and part II of
30 chapter 408, using criteria established by the United States
31 Department of Health and Human Services as general guidelines
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1 for modeling drug-free workplace laboratories the state
2 drug-testing program, concerning, but not limited to:
3 1. Standards for drug-testing laboratory licensing and
4 denial, suspension, and revocation of a license.
5 2. Urine, hair, blood, and other body specimens and
6 minimum specimen amounts which are appropriate for drug
7 testing, not inconsistent with other provisions established by
8 law.
9 3. Methods of analysis and procedures to ensure
10 reliable drug-testing results, including standards for initial
11 tests and confirmation tests, not inconsistent with other
12 provisions established by law.
13 4. Minimum cutoff detection levels for drugs or their
14 metabolites for the purposes of determining a positive test
15 result, not inconsistent with other provisions established by
16 law.
17 5. Chain-of-custody procedures to ensure proper
18 identification, labeling, and handling of specimens being
19 tested, not inconsistent with other provisions established by
20 law.
21 6. Retention, storage, and transportation procedures
22 to ensure reliable results on confirmation tests and retests.
23 7. A list of the most common medications by brand name
24 or common name, as applicable, as well as by chemical name,
25 which may alter or affect a drug test.
26
27 This section shall not be construed to eliminate the
28 bargainable rights as provided in the collective bargaining
29 process where applicable.
30 (17) LICENSE FEE.--Fees from licensure of drug-testing
31 laboratories shall be sufficient to carry out the
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1 responsibilities of the Agency for Health Care Administration
2 for the regulation of drug-testing laboratories. In accordance
3 with s. 408.805, applicants and licensees shall pay a fee for
4 each license application submitted under this part, part II of
5 chapter 408, and applicable rules. The fee shall be not less
6 than $16,000 or more than $20,000 per biennium and shall be
7 established by rule. The Agency for Health Care Administration
8 shall collect fees for all licenses issued under this part.
9 Each nonrefundable fee shall be due at the time of application
10 and shall be payable to the Agency for Health Care
11 Administration to be deposited in a trust fund administered by
12 the Agency for Health Care Administration and used only for
13 the purposes of this section. The fee schedule is as
14 follows: For licensure as a drug-testing laboratory, an
15 annual fee of not less than $8,000 or more than $10,000 per
16 fiscal year; for late filing of an application for renewal, an
17 additional fee of $500 per day shall be charged.
18 Section 2. Paragraph (b) of subsection (4) of section
19 381.78, Florida Statutes, is amended to read:
20 381.78 Advisory council on brain and spinal cord
21 injuries.--
22 (4) The council shall:
23 (b) Annually appoint a five-member committee composed
24 of one individual who has a brain injury or has a family
25 member with a brain injury, one individual who has a spinal
26 cord injury or has a family member with a spinal cord injury,
27 and three members who shall be chosen from among these
28 representative groups: physicians, other allied health
29 professionals, administrators of brain and spinal cord injury
30 programs, and representatives from support groups with
31 expertise in areas related to the rehabilitation of
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1 individuals who have brain or spinal cord injuries, except
2 that one and only one member of the committee shall be an
3 administrator of a transitional living facility. Membership on
4 the council is not a prerequisite for membership on this
5 committee.
6 1. The committee shall perform onsite visits to those
7 transitional living facilities identified by the Agency for
8 Health Care Administration as being in possible violation of
9 the statutes and rules regulating such facilities. The
10 committee members have the same rights of entry and inspection
11 granted under s. 400.805(4) s. 400.805(8) to designated
12 representatives of the agency.
13 2. Factual findings of the committee resulting from an
14 onsite investigation of a facility pursuant to subparagraph 1.
15 shall be adopted by the agency in developing its
16 administrative response regarding enforcement of statutes and
17 rules regulating the operation of the facility.
18 3. Onsite investigations by the committee shall be
19 funded by the Health Care Trust Fund.
20 4. Travel expenses for committee members shall be
21 reimbursed in accordance with s. 112.061.
22 5. Members of the committee shall recuse themselves
23 from participating in any investigation that would create a
24 conflict of interest under state law, and the council shall
25 replace the member, either temporarily or permanently.
26 Section 3. Section 383.301, Florida Statutes, is
27 amended to read:
28 383.301 Licensure and regulation of birth centers;
29 legislative intent.--It is the intent of the Legislature to
30 provide for the protection of public health and safety in the
31 establishment, maintenance, and operation of birth centers by
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1 providing for licensure of birth centers and for the
2 development, establishment, and enforcement of minimum
3 standards with respect to birth centers. The requirements of
4 part II of chapter 408 shall apply to the provision of
5 services that require licensure pursuant to ss. 383.30-383.335
6 and part II of chapter 408 and to entities licensed by or
7 applying for such licensure from the Agency for Health Care
8 Administration pursuant to ss. 383.30-383.335. A license
9 issued by the agency is required in order to operate a birth
10 center in this state.
11 Section 4. Section 383.304, Florida Statutes, is
12 repealed.
13 Section 5. Section 383.305, Florida Statutes, is
14 amended to read:
15 383.305 Licensure; issuance, renewal, denial,
16 suspension, revocation; fees; background screening.--
17 (1)(a) In accordance with s. 408.805, an applicant or
18 a licensee shall pay a fee for each license application
19 submitted under ss. 383.30-383.335 and part II of chapter 408.
20 The amount of the fee shall be established by rule. Upon
21 receipt of an application for a license and the license fee,
22 the agency shall issue a license if the applicant and facility
23 have received all approvals required by law and meet the
24 requirements established under ss. 383.30-383.335 and by rules
25 promulgated hereunder.
26 (b) A provisional license may be issued to any birth
27 center that is in substantial compliance with ss.
28 383.30-383.335 and with the rules of the agency. A provisional
29 license may be granted for a period of no more than 1 year
30 from the effective date of rules adopted by the agency, shall
31
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1 expire automatically at the end of its term, and may not be
2 renewed.
3 (c) A license, unless sooner suspended or revoked,
4 automatically expires 1 year from its date of issuance and is
5 renewable upon application for renewal and payment of the fee
6 prescribed, provided the applicant and the birth center meet
7 the requirements established under ss. 383.30-383.335 and by
8 rules promulgated hereunder. A complete application for
9 renewal of a license shall be made 90 days prior to expiration
10 of the license on forms provided by the agency.
11 (2) An application for a license, or renewal thereof,
12 shall be made to the agency upon forms provided by it and
13 shall contain such information as the agency reasonably
14 requires, which may include affirmative evidence of ability to
15 comply with applicable laws and rules.
16 (3)(a) Each application for a birth center license, or
17 renewal thereof, shall be accompanied by a license fee. Fees
18 shall be established by rule of the agency. Such fees are
19 payable to the agency and shall be deposited in a trust fund
20 administered by the agency, to be used for the sole purpose of
21 carrying out the provisions of ss. 383.30-383.335.
22 (b) The fees established pursuant to ss.
23 383.30-383.335 shall be based on actual costs incurred by the
24 agency in the administration of its duties under such
25 sections.
26 (4) Each license is valid only for the person or
27 governmental unit to whom or which it is issued; is not
28 subject to sale, assignment, or other transfer, voluntary or
29 involuntary; and is not valid for any premises other than
30 those for which it was originally issued.
31
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1 (5) Each license shall be posted in a conspicuous
2 place on the licensed premises.
3 (6) Whenever the agency finds that there has been a
4 substantial failure to comply with the requirements
5 established under ss. 383.30-383.335 or in rules adopted under
6 those sections, it is authorized to deny, suspend, or revoke a
7 license.
8 (2)(7) Each applicant for licensure and each licensee
9 must comply with the following requirements of this chapter
10 and part II of chapter 408.:
11 (a) Upon receipt of a completed, signed, and dated
12 application, the agency shall require background screening, in
13 accordance with the level 2 standards for screening set forth
14 in chapter 435, of the managing employee, or other similarly
15 titled individual who is responsible for the daily operation
16 of the center, and of the financial officer, or other
17 similarly titled individual who is responsible for the
18 financial operation of the center, including billings for
19 patient care and services. The applicant must comply with the
20 procedures for level 2 background screening as set forth in
21 chapter 435 as well as the requirements of s. 435.03(3).
22 (b) The agency may require background screening of any
23 other individual who is an applicant if the agency has
24 probable cause to believe that he or she has been convicted of
25 a crime or has committed any other offense prohibited under
26 the level 2 standards for screening set forth in chapter 435.
27 (c) Proof of compliance with the level 2 background
28 screening requirements of chapter 435 which has been submitted
29 within the previous 5 years in compliance with any other
30 health care licensure requirements of this state is acceptable
31 in fulfillment of the requirements of paragraph (a).
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1 (d) A provisional license may be granted to an
2 applicant when each individual required by this section to
3 undergo background screening has met the standards for the
4 Department of Law Enforcement background check, but the agency
5 has not yet received background screening results from the
6 Federal Bureau of Investigation, or a request for a
7 disqualification exemption has been submitted to the agency as
8 set forth in chapter 435 but a response has not yet been
9 issued. A standard license may be granted to the applicant
10 upon the agency's receipt of a report of the results of the
11 Federal Bureau of Investigation background screening for each
12 individual required by this section to undergo background
13 screening which confirms that all standards have been met, or
14 upon the granting of a disqualification exemption by the
15 agency as set forth in chapter 435. Any other person who is
16 required to undergo level 2 background screening may serve in
17 his or her capacity pending the agency's receipt of the report
18 from the Federal Bureau of Investigation. However, the person
19 may not continue to serve if the report indicates any
20 violation of background screening standards and a
21 disqualification exemption has not been requested of and
22 granted by the agency as set forth in chapter 435.
23 (e) Each applicant must submit to the agency, with its
24 application, a description and explanation of any exclusions,
25 permanent suspensions, or terminations of the applicant from
26 the Medicare or Medicaid programs. Proof of compliance with
27 the requirements for disclosure of ownership and control
28 interests under the Medicaid or Medicare programs shall be
29 accepted in lieu of this submission.
30 (f) Each applicant must submit to the agency a
31 description and explanation of any conviction of an offense
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1 prohibited under the level 2 standards of chapter 435 by a
2 member of the board of directors of the applicant, its
3 officers, or any individual owning 5 percent or more of the
4 applicant. This requirement does not apply to a director of a
5 not-for-profit corporation or organization if the director
6 serves solely in a voluntary capacity for the corporation or
7 organization, does not regularly take part in the day-to-day
8 operational decisions of the corporation or organization,
9 receives no remuneration for his or her services on the
10 corporation or organization's board of directors, and has no
11 financial interest and has no family members with a financial
12 interest in the corporation or organization, provided that the
13 director and the not-for-profit corporation or organization
14 include in the application a statement affirming that the
15 director's relationship to the corporation satisfies the
16 requirements of this paragraph.
17 (g) A license may not be granted to an applicant if
18 the applicant or managing employee has been found guilty of,
19 regardless of adjudication, or has entered a plea of nolo
20 contendere or guilty to, any offense prohibited under the
21 level 2 standards for screening set forth in chapter 435,
22 unless an exemption from disqualification has been granted by
23 the agency as set forth in chapter 435.
24 (h) The agency may deny or revoke licensure if the
25 applicant:
26 1. Has falsely represented a material fact in the
27 application required by paragraph (e) or paragraph (f), or has
28 omitted any material fact from the application required by
29 paragraph (e) or paragraph (f); or
30
31
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1 2. Has had prior action taken against the applicant
2 under the Medicaid or Medicare program as set forth in
3 paragraph (e).
4 (i) An application for license renewal must contain
5 the information required under paragraphs (e) and (f).
6 Section 6. Section 383.309, Florida Statutes, is
7 amended to read:
8 383.309 Minimum standards for birth centers; rules and
9 enforcement.--
10 (1) The agency shall adopt and enforce rules to
11 administer ss. 383.30-383.335 and part II of chapter 408,
12 which rules shall include, but are not limited to, reasonable
13 and fair minimum standards for ensuring that:
14 (a) Sufficient numbers and qualified types of
15 personnel and occupational disciplines are available at all
16 times to provide necessary and adequate patient care and
17 safety.
18 (b) Infection control, housekeeping, sanitary
19 conditions, disaster plan, and medical record procedures that
20 will adequately protect patient care and provide safety are
21 established and implemented.
22 (c) Licensed facilities are established, organized,
23 and operated consistent with established programmatic
24 standards.
25 (2) Any licensed facility that is in operation at the
26 time of adoption of any applicable rule under ss.
27 383.30-383.335 shall be given a reasonable time under the
28 particular circumstances, not to exceed 1 year after the date
29 of such adoption, within which to comply with such rule.
30 (2)(3) The agency may not establish any rule governing
31 the design, construction, erection, alteration, modification,
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1 repair, or demolition of birth centers. It is the intent of
2 the Legislature to preempt that function to the Florida
3 Building Commission and the State Fire Marshal through
4 adoption and maintenance of the Florida Building Code and the
5 Florida Fire Prevention Code. However, the agency shall
6 provide technical assistance to the commission and the State
7 Fire Marshal in updating the construction standards of the
8 Florida Building Code and the Florida Fire Prevention Code
9 which govern birth centers. In addition, the agency may
10 enforce the special-occupancy provisions of the Florida
11 Building Code and the Florida Fire Prevention Code which apply
12 to birth centers in conducting any inspection authorized under
13 this chapter or part II of chapter 408.
14 Section 7. Subsection (1) of section 383.315, Florida
15 Statutes, is amended to read:
16 383.315 Agreements with consultants for advice or
17 services; maintenance.--
18 (1) A birth center shall maintain in writing a
19 consultation agreement, signed within the current license
20 period year, with each consultant who has agreed to provide
21 advice and services to the birth center as requested.
22 Section 8. Section 383.324, Florida Statutes, is
23 amended to read:
24 383.324 Inspections and investigations; inspection
25 fees.--
26 (1) The agency shall make or cause to be made such
27 inspections and investigations as it deems necessary.
28 (2) Each facility licensed under s. 383.305 shall pay
29 to the agency, at the time of inspection, an inspection fee
30 established by rule of the agency. In addition to the
31 requirements of part II of chapter 408,
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1 (3) the agency shall coordinate all periodic
2 inspections for licensure made by the agency to ensure that
3 the cost to the facility of such inspections and the
4 disruption of services by such inspections is minimized.
5 Section 9. Section 383.325, Florida Statutes, is
6 repealed.
7 Section 10. Section 383.33, Florida Statutes, is
8 amended to read:
9 383.33 Administrative penalties; emergency orders;
10 moratorium on admissions.--
11 (1)(a) In addition to the requirements of part II of
12 chapter 408, the agency may deny, revoke, or suspend a
13 license, or impose an administrative fine not to exceed $500
14 per violation per day, for the violation of any provision of
15 ss. 383.30-383.335, part II of chapter 408, or applicable
16 rules or any rule adopted under ss. 383.30-383.335. Each day
17 of violation constitutes a separate violation and is subject
18 to a separate fine.
19 (2)(b) In determining the amount of the fine to be
20 levied for a violation, as provided in this section paragraph
21 (a), the following factors shall be considered:
22 (a)1. The severity of the violation, including the
23 probability that death or serious harm to the health or safety
24 of any person will result or has resulted; the severity of the
25 actual or potential harm; and the extent to which the
26 provisions of ss. 383.30-383.335, part II of chapter 408, or
27 applicable rules were violated.
28 (b)2. Actions taken by the licensee to correct the
29 violations or to remedy complaints.
30 (c)3. Any previous violations by the licensee.
31
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1 (c) All amounts collected pursuant to this section
2 shall be deposited into a trust fund administered by the
3 agency to be used for the sole purpose of carrying out the
4 provisions of ss.383.30-383.335.
5 (2) The agency may issue an emergency order
6 immediately suspending or revoking a license when it
7 determines that any condition in the licensed facility
8 presents a clear and present danger to the public health and
9 safety.
10 (2)(3) In accordance with part II of chapter 408, the
11 agency may impose an immediate moratorium on elective
12 admissions to any licensed facility, building or portion
13 thereof, or service when the agency determines that any
14 condition in the facility presents a threat to the public
15 health or safety.
16 Section 11. Section 383.331, Florida Statutes, is
17 repealed.
18 Section 12. Section 383.332, Florida Statutes, is
19 amended to read:
20 383.332 Establishing, managing, or operating a birth
21 center without a license; penalty.--Any person who
22 establishes, conducts, manages, or operates any birth center
23 facility without a license issued under s. 383.305 and part II
24 of chapter 408 commits is guilty of a misdemeanor and, upon
25 conviction, shall be fined not more than $100 for the first
26 offense and not more than $500 for each subsequent offense;
27 and each day of continuing violation after conviction shall be
28 considered a separate offense.
29 Section 13. Subsection (1) of section 383.335, Florida
30 Statutes, is amended to read:
31 383.335 Partial exemptions.--
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1 (1) Any facility that which was providing obstetrical
2 and gynecological surgical services and was owned and operated
3 by a board-certified obstetrician on June 15, 1984, and that
4 would which otherwise be subject to licensure under ss.
5 383.30-383.335 as a birth center, is exempt from the
6 provisions of ss. 383.30-383.335 and part II of chapter 408
7 which restrict the provision of surgical services and outlet
8 forceps delivery and the administration of anesthesia at birth
9 centers. The agency shall adopt rules specifically related to
10 the performance of such services and the administration of
11 anesthesia at such facilities.
12 Section 14. Subsection (4) of section 383.50, Florida
13 Statutes, is amended to read:
14 383.50 Treatment of abandoned newborn infant.--
15 (4) Each hospital of this state subject to s. 395.1041
16 shall, and any other hospital may, admit and provide all
17 necessary emergency services and care, as defined in s.
18 395.002(9)(10), to any newborn infant left with the hospital
19 in accordance with this section. The hospital or any of its
20 licensed health care professionals shall consider these
21 actions as implied consent for treatment, and a hospital
22 accepting physical custody of a newborn infant has implied
23 consent to perform all necessary emergency services and care.
24 The hospital or any of its licensed health care professionals
25 is immune from criminal or civil liability for acting in good
26 faith in accordance with this section. Nothing in this
27 subsection limits liability for negligence.
28 Section 15. Subsection (5) of section 390.011, Florida
29 Statutes, is amended to read:
30 390.011 Definitions.--As used in this chapter, the
31 term:
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1 (5) "Hospital" means a facility as defined in s.
2 395.002(12) and licensed under chapter 395 and part II of
3 chapter 408.
4 Section 16. Subsection (1) of section 390.012, Florida
5 Statutes, is amended to read:
6 390.012 Powers of agency; rules; disposal of fetal
7 remains.--
8 (1) The agency may shall have the authority to develop
9 and enforce rules pursuant to ss. 390.001-390.018 and part II
10 of chapter 408 for the health, care, and treatment of persons
11 in abortion clinics and for the safe operation of such
12 clinics.
13 (a) The rules shall be reasonably related to the
14 preservation of maternal health of the clients.
15 (b) The rules shall be in accordance with s. 797.03
16 and may not impose an unconstitutional burden on a woman's
17 freedom to decide whether to terminate her pregnancy.
18 (c) The rules shall provide for:
19 1. The performance of pregnancy termination procedures
20 only by a licensed physician.
21 2. The making, protection, and preservation of patient
22 records, which shall be treated as medical records under
23 chapter 458.
24 Section 17. Section 390.013, Florida Statutes, is
25 repealed.
26 Section 18. Section 390.014, Florida Statutes, is
27 amended to read:
28 390.014 Licenses; fees, display, etc.--
29 (1) The requirements of part II of chapter 408 shall
30 apply to the provision of services that require licensure
31 pursuant to ss. 390.011-390.018 and part II of chapter 408 and
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1 to entities licensed by or applying for such licensure from
2 the Agency for Health Care Administration pursuant to ss.
3 390.011-390.018. A license issued by the agency is required in
4 order to operate a clinic in this state. No abortion clinic
5 shall operate in this state without a currently effective
6 license issued by the agency.
7 (2) A separate license shall be required for each
8 clinic maintained on separate premises, even though it is
9 operated by the same management as another clinic; but a
10 separate license shall not be required for separate buildings
11 on the same premises.
12 (3) In accordance with s. 408.805, an applicant or
13 licensee shall pay a fee for each license application
14 submitted under this part and part II of chapter 408. The
15 amount of the fee shall be established by rule and The annual
16 license fee required for a clinic shall be nonrefundable and
17 shall be reasonably calculated to cover the cost of regulation
18 under this chapter, but may not be less than $70 or $35 nor
19 more than $500 $250.
20 (4) Counties and municipalities applying for licenses
21 under this act shall be exempt from the payment of the license
22 fees.
23 (5) The license shall be displayed in a conspicuous
24 place inside the clinic.
25 (6) A license shall be valid only for the clinic to
26 which it is issued, and it shall not be subject to sale,
27 assignment, or other transfer, voluntary or involuntary. No
28 license shall be valid for any premises other than those for
29 which it was originally issued.
30 Section 19. Section 390.015, Florida Statutes, is
31 amended to read:
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1 390.015 Application for license.--
2 (1) In addition to the requirements of part II of
3 chapter 408, an application for a license to operate an
4 abortion clinic shall be made to the agency and must include
5 on a form furnished by it for that purpose. The application
6 shall be accompanied by the applicable license fee.
7 (2) The application, which shall be made under oath,
8 shall contain, among other things, the following:
9 (a) The name and address of the applicant if the
10 applicant is an individual; or if the applicant is a firm,
11 partnership, or association, the name and address of each
12 member thereof; or if the applicant is a corporation, its name
13 and address and the name and address of each of its officers.
14 (b) The name by which the clinic is to be known.
15 (c) the location of the clinic for which application
16 is made and a statement that local zoning ordinances permit
17 such location.
18 (d) The name of the person or persons under whose
19 management or supervision the clinic will be operated.
20 (3) Each applicant for licensure must comply with the
21 following requirements:
22 (a) Upon receipt of a completed, signed, and dated
23 application, the agency shall require background screening, in
24 accordance with the level 2 standards for screening set forth
25 in chapter 435, of the managing employee, or other similarly
26 titled individual who is responsible for the daily operation
27 of the clinic, and financial officer, or other similarly
28 titled individual who is responsible for the financial
29 operation of the clinic, including billings for patient care
30 and services. The applicant must comply with the procedures
31
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1 for level 2 background screening as set forth in chapter 435,
2 as well as the requirements of s. 435.03(3).
3 (b) The agency may require background screening of any
4 other individual who is an applicant if the agency has
5 probable cause to believe that he or she has been convicted of
6 a crime or has committed any other offense prohibited under
7 the level 2 standards for screening set forth in chapter 435.
8 (c) Proof of compliance with the level 2 background
9 screening requirements of chapter 435 which has been submitted
10 within the previous 5 years in compliance with any other
11 health care licensure requirements of this state is acceptable
12 in fulfillment of the requirements of paragraph (a).
13 (d) A provisional license may be granted to an
14 applicant when each individual required by this section to
15 undergo background screening has met the standards for the
16 Department of Law Enforcement background check, but the agency
17 has not yet received background screening results from the
18 Federal Bureau of Investigation, or a request for a
19 disqualification exemption has been submitted to the agency as
20 set forth in chapter 435 but a response has not yet been
21 issued. A standard license may be granted to the applicant
22 upon the agency's receipt of a report of the results of the
23 Federal Bureau of Investigation background screening for each
24 individual required by this section to undergo background
25 screening which confirms that all standards have been met, or
26 upon the granting of a disqualification exemption by the
27 agency as set forth in chapter 435. Any other person who is
28 required to undergo level 2 background screening may serve in
29 his or her capacity pending the agency's receipt of the report
30 from the Federal Bureau of Investigation. However, the person
31 may not continue to serve if the report indicates any
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1 violation of background screening standards and a
2 disqualification exemption has not been requested of and
3 granted by the agency as set forth in chapter 435.
4 (e) Each applicant must submit to the agency, with its
5 application, a description and explanation of any exclusions,
6 permanent suspensions, or terminations of the applicant from
7 the Medicare or Medicaid programs. Proof of compliance with
8 the requirements for disclosure of ownership and control
9 interests under the Medicaid or Medicare programs shall be
10 accepted in lieu of this submission.
11 (f) Each applicant must submit to the agency a
12 description and explanation of any conviction of an offense
13 prohibited under the level 2 standards of chapter 435 by a
14 member of the board of directors of the applicant, its
15 officers, or any individual owning 5 percent or more of the
16 applicant. This requirement does not apply to a director of a
17 not-for-profit corporation or organization if the director
18 serves solely in a voluntary capacity for the corporation or
19 organization, does not regularly take part in the day-to-day
20 operational decisions of the corporation or organization,
21 receives no remuneration for his or her services on the
22 corporation or organization's board of directors, and has no
23 financial interest and has no family members with a financial
24 interest in the corporation or organization, provided that the
25 director and the not-for-profit corporation or organization
26 include in the application a statement affirming that the
27 director's relationship to the corporation satisfies the
28 requirements of this paragraph.
29 (g) A license may not be granted to an applicant if
30 the applicant or managing employee has been found guilty of,
31 regardless of adjudication, or has entered a plea of nolo
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1 contendere or guilty to, any offense prohibited under the
2 level 2 standards for screening set forth in chapter 435,
3 unless an exemption from disqualification has been granted by
4 the agency as set forth in chapter 435.
5 (h) The agency may deny or revoke licensure if the
6 applicant:
7 1. Has falsely represented a material fact in the
8 application required by paragraph (e) or paragraph (f), or has
9 omitted any material fact from the application required by
10 paragraph (e) or paragraph (f); or
11 2. Has had prior action taken against the applicant
12 under the Medicaid or Medicare program as set forth in
13 paragraph (e).
14 (i) An application for license renewal must contain
15 the information required under paragraphs (e) and (f).
16 Section 20. Section 390.016, Florida Statutes, is
17 repealed.
18 Section 21. Section 390.017, Florida Statutes, is
19 repealed.
20 Section 22. Section 390.018, Florida Statutes, is
21 amended to read:
22 390.018 Administrative fine penalty in lieu of
23 revocation or suspension.--In addition to the requirements of
24 part II of chapter 408 If the agency finds that one or more
25 grounds exist for the revocation or suspension of a license
26 issued to an abortion clinic, the agency may, in lieu of such
27 suspension or revocation, impose a fine upon the clinic in an
28 amount not to exceed $1,000 for each violation of any
29 provision of this part, part II of chapter 408, or applicable
30 rules. The fine shall be paid to the agency within 60 days
31 from the date of entry of the administrative order. If the
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1 licensee fails to pay the fine in its entirety to the agency
2 within the period allowed, the license of the licensee shall
3 stand suspended, revoked, or renewal or continuation may be
4 refused, as the case may be, upon expiration of such period
5 and without any further administrative or judicial
6 proceedings.
7 Section 23. Section 390.019, Florida Statutes, is
8 repealed.
9 Section 24. Section 390.021, Florida Statutes, is
10 repealed.
11 Section 25. Subsection (13) of section 394.455,
12 Florida Statutes, is amended to read:
13 394.455 Definitions.--As used in this part, unless the
14 context clearly requires otherwise, the term:
15 (13) "Hospital" means a facility as defined in s.
16 395.002 and licensed under chapter 395 and part II of chapter
17 408.
18 Section 26. Subsection (7) of section 394.4787,
19 Florida Statutes, is amended to read:
20 394.4787 Definitions; ss. 394.4786, 394.4787,
21 394.4788, and 394.4789.--As used in this section and ss.
22 394.4786, 394.4788, and 394.4789:
23 (7) "Specialty psychiatric hospital" means a hospital
24 licensed by the agency pursuant to s. 395.002(28) and part II
25 of chapter 408 s. 395.002(29) as a specialty psychiatric
26 hospital.
27 Section 27. Subsections (3) through (25) of section
28 394.67, Florida Statutes, are renumbered as subsections (2)
29 through (24), respectively, and present subsections (2) and
30 (4) of that section are amended to read:
31 394.67 Definitions.--As used in this part, the term:
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1 (2) "Applicant" means an individual applicant, or any
2 officer, director, agent, managing employee, or affiliated
3 person, or any partner or shareholder having an ownership
4 interest equal to a 5-percent or greater interest in the
5 corporation, partnership, or other business entity.
6 (3)(4) "Crisis services" means short-term evaluation,
7 stabilization, and brief intervention services provided to a
8 person who is experiencing an acute mental or emotional
9 crisis, as defined in subsection (17) (18), or an acute
10 substance abuse crisis, as defined in subsection (18) (19), to
11 prevent further deterioration of the person's mental health.
12 Crisis services are provided in settings such as a crisis
13 stabilization unit, an inpatient unit, a short-term
14 residential treatment program, a detoxification facility, or
15 an addictions receiving facility; at the site of the crisis by
16 a mobile crisis response team; or at a hospital on an
17 outpatient basis.
18 Section 28. Subsection (3) of section 394.74, Florida
19 Statutes, is amended to read:
20 394.74 Contracts for provision of local substance
21 abuse and mental health programs.--
22 (3) Contracts shall include, but are not limited to:
23 (a) A provision that, within the limits of available
24 resources, substance abuse and mental health crisis services,
25 as defined in s. 394.67(3)(4), shall be available to any
26 individual residing or employed within the service area,
27 regardless of ability to pay for such services, current or
28 past health condition, or any other factor;
29 (b) A provision that such services be available with
30 priority of attention being given to individuals who exhibit
31
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1 symptoms of chronic or acute substance abuse or mental illness
2 and who are unable to pay the cost of receiving such services;
3 (c) A provision that every reasonable effort to
4 collect appropriate reimbursement for the cost of providing
5 substance abuse and mental health services to persons able to
6 pay for services, including first-party payments and
7 third-party payments, shall be made by facilities providing
8 services pursuant to this act;
9 (d) A program description and line-item operating
10 budget by program service component for substance abuse and
11 mental health services, provided the entire proposed operating
12 budget for the service provider will be displayed;
13 (e) A provision that client demographic, service, and
14 outcome information required for the department's Mental
15 Health and Substance Abuse Data System be submitted to the
16 department by a date specified in the contract. The department
17 may not pay the provider unless the required information has
18 been submitted by the specified date; and
19 (f) A requirement that the contractor must conform to
20 department rules and the priorities established thereunder.
21 Section 29. Subsections (1) and (4) of section 394.82,
22 Florida Statutes, are amended to read:
23 394.82 Funding of expanded services.--
24 (1) Pursuant to the General Appropriations Acts for
25 the 2001-2002 and 2002-2003 fiscal years, funds appropriated
26 to the Department of Children and Family Services for the
27 purpose of expanding community mental health services must be
28 used to implement programs that emphasize crisis services as
29 defined in s. 394.67(3)(4) and treatment services,
30 rehabilitative services, support services, and case management
31 services, as defined in s. 394.67(15)(16). Following the
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1 2002-2003 fiscal year, the Department of Children and Family
2 Services must continue to expand the provision of these
3 community mental health services.
4 (4) By January 1, 2004, the crisis services defined in
5 s. 394.67(3)(4) shall be implemented, as appropriate, in the
6 state's public community mental health system to serve
7 children and adults who are experiencing an acute mental or
8 emotional crisis, as defined in s. 394.67(17)(18). By January
9 1, 2006, the mental health services defined in s.
10 394.67(15)(16) shall be implemented, as appropriate, in the
11 state's public community mental health system to serve adults
12 and older adults who have a severe and persistent mental
13 illness and to serve children who have a serious emotional
14 disturbance or mental illness, as defined in s. 394.492(6).
15 Section 30. Section 394.875, Florida Statutes, is
16 amended to read:
17 394.875 Crisis stabilization units, residential
18 treatment facilities, and residential treatment centers for
19 children and adolescents; authorized services; license
20 required; penalties.--
21 (1)(a) The purpose of a crisis stabilization unit is
22 to stabilize and redirect a client to the most appropriate and
23 least restrictive community setting available, consistent with
24 the client's needs. Crisis stabilization units may screen,
25 assess, and admit for stabilization persons who present
26 themselves to the unit and persons who are brought to the unit
27 under s. 394.463. Clients may be provided 24-hour observation,
28 medication prescribed by a physician or psychiatrist, and
29 other appropriate services. Crisis stabilization units shall
30 provide services regardless of the client's ability to pay and
31 shall be limited in size to a maximum of 30 beds.
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1 (b) The purpose of a residential treatment facility is
2 to be a part of a comprehensive treatment program for mentally
3 ill individuals in a community-based residential setting.
4 (c) The purpose of a residential treatment center for
5 children and adolescents is to provide mental health
6 assessment and treatment services pursuant to ss. 394.491,
7 394.495, and 394.496 to children and adolescents who meet the
8 target population criteria specified in s. 394.493(1)(a), (b),
9 or (c).
10 (2) The requirements of part II of chapter 408 apply
11 to the provision of services that require licensure under ss.
12 394.455-394.904 and part II of chapter 408 and to entities
13 licensed by or applying for such licensure from the Agency for
14 Health Care Administration pursuant to ss. 394.455-394.904. A
15 license issued by the agency is required in order to operate
16 It is unlawful for any entity to hold itself out as a crisis
17 stabilization unit, a residential treatment facility, or a
18 residential treatment center for children and adolescents, or
19 to act as a crisis stabilization unit, a residential treatment
20 facility, or a residential treatment center for children and
21 adolescents in this state, unless it is licensed by the agency
22 pursuant to this chapter.
23 (3) Any person who violates subsection (2) is guilty
24 of a misdemeanor of the first degree, punishable as provided
25 in s. 775.082 or s. 775.083.
26 (4) The agency may maintain an action in circuit court
27 to enjoin the unlawful operation of a crisis stabilization
28 unit, a residential treatment facility, or a residential
29 treatment center for children and adolescents if the agency
30 first gives the violator 14 days' notice of its intention to
31
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1 maintain such action and if the violator fails to apply for
2 licensure within such 14-day period.
3 (3)(5) The following are exempt from licensure as
4 required in ss. 394.455-394.904 Subsection (2) does not apply
5 to:
6 (a) Homes for special services licensed under chapter
7 400.; or
8 (b) Nursing homes licensed under chapter 400.
9 (c) Comprehensive transitional education programs
10 licensed under s. 393.067.
11 (4)(6) The department, in consultation with the
12 agency, may establish multiple license classifications for
13 residential treatment facilities.
14 (5)(7) The agency may not issue a license to a crisis
15 stabilization unit unless the unit receives state mental
16 health funds and is affiliated with a designated public
17 receiving facility.
18 (6)(8) The agency may issue a license for a crisis
19 stabilization unit or short-term residential treatment
20 facility, certifying the number of authorized beds for such
21 facility as indicated by existing need and available
22 appropriations. The agency may disapprove an application for
23 such a license if it determines that a facility should not be
24 licensed pursuant to the provisions of this chapter. Any
25 facility operating beds in excess of those authorized by the
26 agency shall, upon demand of the agency, reduce the number of
27 beds to the authorized number, forfeit its license, or provide
28 evidence of a license issued pursuant to chapter 395 for the
29 excess beds.
30 (7)(9) A children's crisis stabilization unit which
31 does not exceed 20 licensed beds and which provides separate
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1 facilities or a distinct part of a facility, separate
2 staffing, and treatment exclusively for minors may be located
3 on the same premises as a crisis stabilization unit serving
4 adults. The department, in consultation with the agency, shall
5 adopt rules governing facility construction, staffing and
6 licensure requirements, and the operation of such units for
7 minors.
8 (8)(10) The department, in consultation with the
9 agency, must adopt rules governing a residential treatment
10 center for children and adolescents which specify licensure
11 standards for: admission; length of stay; program and
12 staffing; discharge and discharge planning; treatment
13 planning; seclusion, restraints, and time-out; rights of
14 patients under s. 394.459; use of psychotropic medications;
15 and standards for the operation of such centers.
16 (9)(11) Notwithstanding the provisions of subsection
17 (8), crisis stabilization units may not exceed their licensed
18 capacity by more than 10 percent, nor may they exceed their
19 licensed capacity for more than 3 consecutive working days or
20 for more than 7 days in 1 month.
21 (10)(12) Notwithstanding the other provisions of this
22 section, any facility licensed under former chapter 396 and
23 chapter 397 for detoxification, residential level I care, and
24 outpatient treatment may elect to license concurrently all of
25 the beds at such facility both for that purpose and as a
26 long-term residential treatment facility pursuant to this
27 section, if all of the following conditions are met:
28 (a) The licensure application is received by the
29 department prior to January 1, 1993.
30 (b) On January 1, 1993, the facility was licensed
31 under former chapter 396 and chapter 397 as a facility for
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1 detoxification, residential level I care, and outpatient
2 treatment of substance abuse.
3 (c) The facility restricted its practice to the
4 treatment of law enforcement personnel for a period of at
5 least 12 months beginning after January 1, 1992.
6 (d) The number of beds to be licensed under this
7 chapter is equal to or less than the number of beds licensed
8 under former chapter 396 and chapter 397 as of January 1,
9 1993.
10 (e) The licensee agrees in writing to a condition
11 placed upon the license that the facility will limit its
12 treatment exclusively to law enforcement personnel and their
13 immediate families who are seeking admission on a voluntary
14 basis and who are exhibiting symptoms of posttraumatic stress
15 disorder or other mental health problems, including drug or
16 alcohol abuse, which are directly related to law enforcement
17 work and which are amenable to verbal treatment therapies; the
18 licensee agrees to coordinate the provision of appropriate
19 postresidential care for discharged individuals; and the
20 licensee further agrees in writing that a failure to meet any
21 condition specified in this paragraph shall constitute grounds
22 for a revocation of the facility's license as a residential
23 treatment facility.
24 (f) The licensee agrees that the facility will meet
25 all licensure requirements for a residential treatment
26 facility, including minimum standards for compliance with
27 lifesafety requirements, except those licensure requirements
28 which are in express conflict with the conditions and other
29 provisions specified in this subsection.
30
31
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1 (g) The licensee agrees that the conditions stated in
2 this subsection must be agreed to in writing by any person
3 acquiring the facility by any means.
4
5 Any facility licensed under this subsection is not required to
6 provide any services to any persons except those included in
7 the specified conditions of licensure, and is exempt from any
8 requirements related to the 60-day or greater average length
9 of stay imposed on community-based residential treatment
10 facilities otherwise licensed under this chapter.
11 (13) Each applicant for licensure must comply with the
12 following requirements:
13 (a) Upon receipt of a completed, signed, and dated
14 application, the agency shall require background screening, in
15 accordance with the level 2 standards for screening set forth
16 in chapter 435, of the managing employee and financial
17 officer, or other similarly titled individual who is
18 responsible for the financial operation of the facility,
19 including billings for client care and services. The applicant
20 must comply with the procedures for level 2 background
21 screening as set forth in chapter 435, as well as the
22 requirements of s. 435.03(3).
23 (b) The agency may require background screening of any
24 other individual who is an applicant if the agency has
25 probable cause to believe that he or she has been convicted of
26 a crime or has committed any other offense prohibited under
27 the level 2 standards for screening set forth in chapter 435.
28 (c) Proof of compliance with the level 2 background
29 screening requirements of chapter 435 which has been submitted
30 within the previous 5 years in compliance with any other
31
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1 health care licensure requirements of this state is acceptable
2 in fulfillment of the requirements of paragraph (a).
3 (d) A provisional license may be granted to an
4 applicant when each individual required by this section to
5 undergo background screening has met the standards for the
6 Department of Law Enforcement background check, but the agency
7 has not yet received background screening results from the
8 Federal Bureau of Investigation, or a request for a
9 disqualification exemption has been submitted to the agency as
10 set forth in chapter 435, but a response has not yet been
11 issued. A standard license may be granted to the applicant
12 upon the agency's receipt of a report of the results of the
13 Federal Bureau of Investigation background screening for each
14 individual required by this section to undergo background
15 screening which confirms that all standards have been met, or
16 upon the granting of a disqualification exemption by the
17 agency as set forth in chapter 435. Any other person who is
18 required to undergo level 2 background screening may serve in
19 his or her capacity pending the agency's receipt of the report
20 from the Federal Bureau of Investigation. However, the person
21 may not continue to serve if the report indicates any
22 violation of background screening standards and a
23 disqualification exemption has not been requested of and
24 granted by the agency as set forth in chapter 435.
25 (e) Each applicant must submit to the agency, with its
26 application, a description and explanation of any exclusions,
27 permanent suspensions, or terminations of the applicant from
28 the Medicare or Medicaid programs. Proof of compliance with
29 the requirements for disclosure of ownership and control
30 interests under the Medicaid or Medicare programs shall be
31 accepted in lieu of this submission.
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1 (f) Each applicant must submit to the agency a
2 description and explanation of any conviction of an offense
3 prohibited under the level 2 standards of chapter 435 by a
4 member of the board of directors of the applicant, its
5 officers, or any individual owning 5 percent or more of the
6 applicant. This requirement does not apply to a director of a
7 not-for-profit corporation or organization if the director
8 serves solely in a voluntary capacity for the corporation or
9 organization, does not regularly take part in the day-to-day
10 operational decisions of the corporation or organization,
11 receives no remuneration for his or her services on the
12 corporation or organization's board of directors, and has no
13 financial interest and has no family members with a financial
14 interest in the corporation or organization, provided that the
15 director and the not-for-profit corporation or organization
16 include in the application a statement affirming that the
17 director's relationship to the corporation satisfies the
18 requirements of this paragraph.
19 (g) A license may not be granted to an applicant if
20 the applicant or managing employee has been found guilty of,
21 regardless of adjudication, or has entered a plea of nolo
22 contendere or guilty to, any offense prohibited under the
23 level 2 standards for screening set forth in chapter 435,
24 unless an exemption from disqualification has been granted by
25 the agency as set forth in chapter 435.
26 (h) The agency may deny or revoke licensure if the
27 applicant:
28 1. Has falsely represented a material fact in the
29 application required by paragraph (e) or paragraph (f), or has
30 omitted any material fact from the application required by
31 paragraph (e) or paragraph (f); or
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1 2. Has had prior action taken against the applicant
2 under the Medicaid or Medicare program as set forth in
3 paragraph (e).
4 (i) An application for license renewal must contain
5 the information required under paragraphs (e) and (f).
6 Section 31. Section 394.876, Florida Statutes, is
7 amended to read:
8 394.876 Applications.--
9 (1) In addition to the requirements of part II of
10 chapter 408, any person desiring to be licensed under this
11 chapter shall apply to the agency and on forms provided by the
12 agency. the application must shall contain the following:
13 (a) The name and address of the applicant, the name of
14 the unit or facility, and the address of the unit or facility.
15 (b)1. If the applicant is a partnership, association,
16 or other form of entity other than an individual or a
17 corporation, the name and address of each member or owner of
18 the entity.
19 2. If the applicant is a corporation, the name and
20 address of each director or officer and the name and address
21 of each person holding at least 5 percent ownership interest
22 in the corporation.
23 (c) such information as the department and the agency
24 find necessary to determine the ability of the applicant to
25 carry out its responsibilities under this chapter.
26 (2) The applicant shall furnish proof satisfactory to
27 the agency of its financial ability to operate the unit or
28 facility in accordance with this chapter. An applicant for an
29 original license shall submit a balance sheet and a statement
30 projecting revenues, expenses, taxes, extraordinary items, and
31 other credits and charges for the first 6 months of operation.
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1 (2)(3) The applicant shall provide proof of liability
2 insurance coverage in amounts set by the department and the
3 agency by rule.
4 (4) The agency shall accept proof of accreditation by
5 the Joint Commission on Accreditation of Hospitals in lieu of
6 the information required by subsection (1).
7 Section 32. Section 394.877, Florida Statutes, is
8 amended to read:
9 394.877 Fees.--
10 (1) In accordance with s. 408.805, an applicant or
11 licensee shall pay a fee for each license application
12 submitted under this part, part II of chapter 408, and
13 applicable rules. The amount of the fee shall be established
14 by rule. Each application for licensure or renewal must be
15 accompanied by a fee set by the department, in consultation
16 with the agency, by rule. Such fees shall be reasonably
17 calculated to cover only the cost of regulation under this
18 chapter.
19 (2) All fees collected under this section shall be
20 deposited in the Health Care Trust Fund.
21 Section 33. Section 394.878, Florida Statutes, is
22 repealed.
23 Section 34. Subsections (1), (3), (4), and (5) of
24 section 394.879, Florida Statutes, are amended to read:
25 394.879 Rules; enforcement.--
26 (1) The agency, in consultation with the department,
27 may adopt rules to administer the requirements of part II of
28 chapter 408. The department, in consultation with the agency,
29 shall adopt rules pursuant to ss. 120.536(1) and 120.54 to
30 administer implement the provisions of this chapter,
31
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1 including, at a minimum, rules providing standards to ensure
2 that:
3 (a) Sufficient numbers and types of qualified
4 personnel are on duty and available at all times to provide
5 necessary and adequate client safety and care.
6 (b) Adequate space is provided each client of a
7 licensed facility.
8 (c) Licensed facilities are limited to an appropriate
9 number of beds.
10 (d) Each licensee establishes and implements adequate
11 infection control, housekeeping, sanitation, disaster
12 planning, and medical recordkeeping.
13 (e) Licensed facilities are established, organized,
14 and operated in accordance with programmatic standards of the
15 department.
16 (f) The operation and purposes of these facilities
17 assure individuals' health, safety, and welfare.
18 (g) The use of restraint and seclusion is consistent
19 with recognized best practices and professional judgment; that
20 inherently dangerous restraint or seclusion procedures are
21 prohibited; that limitations are established on the use and
22 duration of restraint and seclusion; that measures are
23 established to ensure the safety of program participants and
24 staff during an incident of restraint or seclusion; that
25 procedures are created for staff to follow before, during, and
26 after incidents of restraint or seclusion; that professional
27 qualifications and training are established for staff who may
28 order or be engaged in the use of restraint or seclusion; and
29 that mandatory reporting, data collection, and data
30 dissemination procedures and requirements are instituted.
31 Rules adopted under this section must require that any
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1 instance of the use of restraint or seclusion shall be
2 documented in the record of the client.
3 (3) The department, in consultation with the agency,
4 shall allow any licensed facility in operation at the time of
5 adoption of any rule a reasonable period, not to exceed 1
6 year, to bring itself into compliance with department rules
7 such rule.
8 (4) In accordance with part II of chapter 408, the
9 agency may impose an administrative penalty of no more than
10 $500 per day against any licensee that violates any rule
11 adopted pursuant to this section and may suspend and or revoke
12 the license and or deny the renewal application of such
13 licensee. In imposing such penalty, the agency shall consider
14 the severity of the violation, actions taken by the licensee
15 to correct the violation, and previous violations by the
16 licensee. Fines collected under this subsection shall be
17 deposited in the Mental Health Facility Licensing Trust Fund.
18 (5) The agency or the department may not adopt any
19 rule governing the design, construction, erection, alteration,
20 modification, repair, or demolition of crisis stabilization
21 units. It is the intent of the Legislature to preempt that
22 function to the Florida Building Commission and the State Fire
23 Marshal through adoption and maintenance of the Florida
24 Building Code and the Florida Fire Prevention Code. However,
25 the agency shall provide technical assistance to the
26 commission and the State Fire Marshal in updating the
27 construction standards of the Florida Building Code and the
28 Florida Fire Prevention Code which govern crisis stabilization
29 units. In addition, the agency may enforce the
30 special-occupancy provisions of the Florida Building Code and
31 the Florida Fire Prevention Code which apply to crisis
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1 stabilization units in conducting any inspection authorized
2 under this part or part II of chapter 408.
3 Section 35. Paragraph (a) of subsection (1) of section
4 394.90, Florida Statutes, is amended to read:
5 394.90 Inspection; right of entry; records.--
6 (1)(a) The department and the agency, in accordance
7 with s. 408.811, and the department may enter and inspect at
8 any time a licensed facility to determine whether the facility
9 is in compliance with this chapter, part II of chapter 408,
10 and applicable the rules of the department.
11 Section 36. Section 394.902, Florida Statutes, is
12 amended to read:
13 394.902 Moratorium on admissions Denial, suspension,
14 and revocation; other remedies.--
15 (1) The agency may issue an emergency order suspending
16 or revoking a license if the agency determines that the
17 continued operation of the licensed facility presents a clear
18 and present danger to the public health or safety.
19 (2) In accordance with part II of chapter 408, the
20 agency may impose a moratorium on elective admissions to a
21 licensee or any program or portion of a licensed facility if
22 the agency determines that any condition in the facility
23 presents a threat to the public health or safety.
24 (3) If the agency determines that an applicant or
25 licensee is not in compliance with this chapter or the rules
26 adopted under this chapter, the agency may deny, suspend, or
27 revoke the license or application or may suspend, revoke, or
28 impose reasonable restrictions on any portion of the license.
29 If a license is revoked, the licensee is barred from
30 submitting any application for licensure to the agency for a
31 period of 6 months following revocation.
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1 (4) The agency may maintain an action in circuit court
2 to enjoin the operation of any licensed or unlicensed facility
3 in violation of this chapter or the rules adopted under this
4 chapter.
5 (5) License denial, suspension, or revocation
6 procedures shall be in accordance with chapter 120.
7 Section 37. Subsection (7) of section 394.907, Florida
8 Statutes, is amended to read:
9 394.907 Community mental health centers; quality
10 assurance programs.--
11 (7) The department shall have access to all records
12 necessary to determine licensee agency compliance with the
13 provisions of this section. The records of quality assurance
14 programs which relate solely to actions taken in carrying out
15 the provisions of this section, and records obtained by the
16 department to determine licensee agency compliance with this
17 section, are confidential and exempt from s. 119.07(1). Such
18 records are not admissible in any civil or administrative
19 action, except in disciplinary proceedings by the Department
20 of Business and Professional Regulation and the appropriate
21 regulatory board, nor shall such records be available to the
22 public as part of the record of investigation for, and
23 prosecution in disciplinary proceedings made available to the
24 public by the Department of Business and Professional
25 Regulation or the appropriate regulatory board. Meetings or
26 portions of meetings of quality assurance program committees
27 that relate solely to actions taken pursuant to this section
28 are exempt from s. 286.011.
29 Section 38. Subsections (5) through (33) of section
30 395.002, Florida Statutes, are renumbered as subsections (4)
31
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1 through (32), respectively, and present subsections (4), (11),
2 and (29) of that section are amended to read:
3 395.002 Definitions.--As used in this chapter:
4 (4) "Applicant" means an individual applicant, or any
5 officer, director, or agent, or any partner or shareholder
6 having an ownership interest equal to a 5-percent or greater
7 interest in the corporation, partnership, or other business
8 entity.
9 (10)(11) "General hospital" means any facility which
10 meets the provisions of subsection (12) (13) and which
11 regularly makes its facilities and services available to the
12 general population.
13 (28)(29) "Specialty hospital" means any facility which
14 meets the provisions of subsection (12) (13), and which
15 regularly makes available either:
16 (a) The range of medical services offered by general
17 hospitals, but restricted to a defined age or gender group of
18 the population;
19 (b) A restricted range of services appropriate to the
20 diagnosis, care, and treatment of patients with specific
21 categories of medical or psychiatric illnesses or disorders;
22 or
23 (c) Intensive residential treatment programs for
24 children and adolescents as defined in subsection (15) (16).
25 Section 39. Section 395.003, Florida Statutes, is
26 amended to read:
27 395.003 Licensure; issuance, renewal, denial,
28 modification, suspension, and revocation.--
29 (1)(a) The requirements of part II of chapter 408
30 apply to the provision of services that require licensure
31 pursuant to ss. 395.001-395.1065 and part II of chapter 408
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1 and to entities licensed by or applying for such licensure
2 from the Agency for Health Care Administration pursuant to ss.
3 395.001-395.1065. A license issued by the agency is required
4 in order to operate A person may not establish, conduct, or
5 maintain a hospital, ambulatory surgical center, or mobile
6 surgical facility in this state without first obtaining a
7 license under this part.
8 (b)1. It is unlawful for a person to use or advertise
9 to the public, in any way or by any medium whatsoever, any
10 facility as a "hospital," "ambulatory surgical center," or
11 "mobile surgical facility" unless such facility has first
12 secured a license under the provisions of this part.
13 2. This part does not apply to veterinary hospitals or
14 to commercial business establishments using the word
15 "hospital," "ambulatory surgical center," or "mobile surgical
16 facility" as a part of a trade name if no treatment of human
17 beings is performed on the premises of such establishments.
18 (c)3. Until July 1, 2006, additional emergency
19 departments located off the premises of licensed hospitals may
20 not be authorized by the agency.
21 (2)(a) Upon the receipt of an application for a
22 license and the license fee, the agency shall issue a license
23 if the applicant and facility have received all approvals
24 required by law and meet the requirements established under
25 this part and in rules. Such license shall include all beds
26 and services located on the premises of the facility.
27 (b) A provisional license may be issued to a new
28 facility or a facility that is in substantial compliance with
29 this part and with the rules of the agency. A provisional
30 license shall be granted for a period of no more than 1 year
31
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1 and shall expire automatically at the end of its term. A
2 provisional license may not be renewed.
3 (c) A license, unless sooner suspended or revoked,
4 shall automatically expire 2 years from the date of issuance
5 and shall be renewable biennially upon application for renewal
6 and payment of the fee prescribed by s. 395.004(2), provided
7 the applicant and licensed facility meet the requirements
8 established under this part and in rules. An application for
9 renewal of a license shall be made 90 days prior to expiration
10 of the license, on forms provided by the agency.
11 (a)(d) In addition to the requirements in part II of
12 chapter 408, the agency shall, at the request of a licensee,
13 issue a single license to a licensee for facilities located on
14 separate premises. Such a license shall specifically state the
15 location of the facilities, the services, and the licensed
16 beds available on each separate premises. If a licensee
17 requests a single license, the licensee shall designate which
18 facility or office is responsible for receipt of information,
19 payment of fees, service of process, and all other activities
20 necessary for the agency to carry out the provisions of this
21 part.
22 (b)(e) The agency shall, at the request of a licensee
23 that is a teaching hospital as defined in s. 408.07(45), issue
24 a single license to a licensee for facilities that have been
25 previously licensed as separate premises, provided such
26 separately licensed facilities, taken together, constitute the
27 same premises as defined in s. 395.002(23)(24). Such license
28 for the single premises shall include all of the beds,
29 services, and programs that were previously included on the
30 licenses for the separate premises. The granting of a single
31 license under this paragraph shall not in any manner reduce
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1 the number of beds, services, or programs operated by the
2 licensee.
3 (c)(f) Intensive residential treatment programs for
4 children and adolescents which have received accreditation
5 from an accrediting organization as defined in s. 395.002(1)
6 and which meet the minimum standards developed by rule of the
7 agency for such programs shall be licensed by the agency under
8 this part.
9 (3)(a) Each license shall be valid only for the person
10 to whom it is issued and shall not be sold, assigned, or
11 otherwise transferred, voluntarily or involuntarily. A license
12 is only valid for the premises for which it was originally
13 issued.
14 (b)1. An application for a new license is required if
15 ownership, a majority of the ownership, or controlling
16 interest of a licensed facility is transferred or assigned and
17 when a lessee agrees to undertake or provide services to the
18 extent that legal liability for operation of the facility
19 rests with the lessee. The application for a new license
20 showing such change shall be made at least 60 days prior to
21 the date of the sale, transfer, assignment, or lease.
22 (3)2. In addition to the requirements of s. 408.807,
23 after a change of ownership has been approved by the agency,
24 the transferee shall be liable for any liability to the state,
25 regardless of when identified, resulting from changes to
26 allowable costs affecting provider reimbursement for Medicaid
27 participation or Public Medical Assistance Trust Fund
28 Assessments, and related administrative fines. The transferee,
29 simultaneously with the transfer of ownership, shall pay or
30 make arrangements to pay to the agency or the department any
31 amount owed to the agency or the department; payment
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1 assurances may be in the form of an irrevocable credit
2 instrument or payment bond acceptable to the agency or the
3 department provided by or on behalf of the transferor. The
4 issuance of a license to the transferee shall be delayed
5 pending payment or until arrangement for payment acceptable to
6 the agency or the department is made.
7 (4) The agency shall issue a license which specifies
8 the service categories and the number of hospital beds in each
9 bed category for which a license is received. Such information
10 shall be listed on the face of the license. All beds which are
11 not covered by any specialty-bed-need methodology shall be
12 specified as general beds. A licensed facility shall not
13 operate a number of hospital beds greater than the number
14 indicated by the agency on the face of the license without
15 approval from the agency under conditions established by rule.
16 (5)(a) Adherence to patient rights, standards of care,
17 and examination and placement procedures provided under part I
18 of chapter 394 shall be a condition of licensure for hospitals
19 providing voluntary or involuntary medical or psychiatric
20 observation, evaluation, diagnosis, or treatment.
21 (b) Any hospital that provides psychiatric treatment
22 to persons under 18 years of age who have emotional
23 disturbances shall comply with the procedures pertaining to
24 the rights of patients prescribed in part I of chapter 394.
25 (c) A hospital that provides birthing services shall
26 affirm in writing as part of the application for a new,
27 provisional, or renewal license that the hospital shall comply
28 with s. 382.013(2)(c), which includes assisting unmarried
29 parents who request assistance in executing a voluntary
30 acknowledgment of paternity. No fine or other sanction under
31 s. 395.1065 may be imposed on a hospital for noncompliance
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1 with s. 382.013(2)(c).(6) No specialty hospital shall provide
2 any service or regularly serve any population group beyond
3 those services or groups specified in its license.
4 (7) Licenses shall be posted in a conspicuous place on
5 each of the licensed premises.
6 (7)(8) In addition to the requirements of part II of
7 chapter 408, whenever the agency finds that there has been a
8 substantial failure to comply with the requirements
9 established under this part or in rules, the agency is
10 authorized to deny, modify, suspend, and or revoke:
11 (a) A license;
12 (b) That part of a license which is limited to a
13 separate premises, as designated on the license; or
14 (c) Licensure approval limited to a facility,
15 building, or portion thereof, or a service, within a given
16 premises.
17 (8)(9) A hospital may not be licensed or relicensed
18 if:
19 (a) The diagnosis-related groups for 65 percent or
20 more of the discharges from the hospital, in the most recent
21 year for which data is available to the Agency for Health Care
22 Administration pursuant to s. 408.061, are for diagnosis,
23 care, and treatment of patients who have:
24 1. Cardiac-related diseases and disorders classified
25 as diagnosis-related groups 103-145, 478-479, 514-518, or
26 525-527;
27 2. Orthopedic-related diseases and disorders
28 classified as diagnosis-related groups 209-256, 471, 491,
29 496-503, or 519-520;
30 3. Cancer-related diseases and disorders classified as
31 diagnosis-related groups 64, 82, 172, 173, 199, 200, 203,
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1 257-260, 274, 275, 303, 306, 307, 318, 319, 338, 344, 346,
2 347, 363, 366, 367, 400-414, 473, or 492; or
3 4. Any combination of the above discharges.
4 (b) The hospital restricts its medical and surgical
5 services to primarily or exclusively cardiac, orthopedic,
6 surgical, or oncology specialties.
7 (9)(10) A hospital licensed as of June 1, 2004, shall
8 be exempt from subsection (8) (9) as long as the hospital
9 maintains the same ownership, facility street address, and
10 range of services that were in existence on June 1, 2004. Any
11 transfer of beds, or other agreements that result in the
12 establishment of a hospital or hospital services within the
13 intent of this section, shall be subject to subsection (8)
14 (9). Unless the hospital is otherwise exempt under subsection
15 (8) (9), the agency shall deny or revoke the license of a
16 hospital that violates any of the criteria set forth in that
17 subsection.
18 (10)(11) The agency may adopt rules implementing the
19 licensure requirements set forth in subsection (8) (9). Within
20 14 days after rendering its decision on a license application
21 or revocation, the agency shall publish its proposed decision
22 in the Florida Administrative Weekly. Within 21 days after
23 publication of the agency's decision, any authorized person
24 may file a request for an administrative hearing. In
25 administrative proceedings challenging the approval, denial,
26 or revocation of a license pursuant to subsection (8) (9), the
27 hearing must be based on the facts and law existing at the
28 time of the agency's proposed agency action. Existing
29 hospitals may initiate or intervene in an administrative
30 hearing to approve, deny, or revoke licensure under subsection
31 (8) (9) based upon a showing that an established program will
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1 be substantially affected by the issuance or renewal of a
2 license to a hospital within the same district or service
3 area.
4 Section 40. Section 395.004, Florida Statutes, is
5 amended to read:
6 395.004 Application for license;, fees; expenses.--
7 (1) In accordance with s. 408.805, an applicant or
8 licensee shall pay a fee for each license application
9 submitted under this part, part II of chapter 408, and
10 applicable rules. The amount of the fee shall be established
11 by rule. An application for a license or renewal thereof shall
12 be made under oath to the agency, upon forms provided by it,
13 and shall contain such information as the agency reasonably
14 requires, which may include affirmative evidence of ability to
15 comply with applicable laws and rules.
16 (2) Each application for a general hospital license,
17 specialty hospital license, ambulatory surgical center
18 license, or mobile surgical facility license, or renewal
19 thereof, shall be accompanied by a license fee, in accordance
20 with the following schedule:
21 (a) The biennial license, provisional license, and
22 license renewal fee required of a facility licensed under this
23 part shall be reasonably calculated to cover the cost of
24 regulation under this part and shall be established by rule at
25 the rate of not less than $9.50 per hospital bed, nor more
26 than $30 per hospital bed, except that the minimum license fee
27 shall be $1,500 and the total fees collected from all licensed
28 facilities may not exceed the cost of properly carrying out
29 the provisions of this part.
30 (b) Such fees shall be paid to the agency and shall be
31 deposited in the Planning and Regulation Trust Fund of the
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1 agency, which is hereby created, for the sole purpose of
2 carrying out the provisions of this part.
3 Section 41. Section 395.0055, Florida Statutes, is
4 repealed.
5 Section 42. Section 395.0161, Florida Statutes, is
6 amended to read:
7 395.0161 Licensure inspection.--
8 (1) In addition to the requirement of s. 408.811, the
9 agency shall make or cause to be made such inspections and
10 investigations as it deems necessary, including:
11 (a) Inspections directed by the federal Centers for
12 Medicare and Medicaid Services Health Care Financing
13 Administration.
14 (b) Validation inspections.
15 (c) Lifesafety inspections.
16 (d) Licensure complaint investigations, including full
17 licensure investigations with a review of all licensure
18 standards as outlined in the administrative rules. Complaints
19 received by the agency from individuals, organizations, or
20 other sources are subject to review and investigation by the
21 agency.
22 (e) Emergency access complaint investigations.
23 (f) Inspections of mobile surgical facilities at each
24 time a facility establishes a new location, prior to the
25 admission of patients. However, such inspections shall not be
26 required when a mobile surgical facility is moved temporarily
27 to a location where medical treatment will not be provided.
28 (2) The agency shall accept, in lieu of its own
29 periodic inspections for licensure, the survey or inspection
30 of an accrediting organization, provided the accreditation of
31 the licensed facility is not provisional and provided the
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1 licensed facility authorizes release of, and the agency
2 receives the report of, the accrediting organization. The
3 agency shall develop, and adopt by rule, criteria for
4 accepting survey reports of accrediting organizations in lieu
5 of conducting a state licensure inspection.
6 (3) In accordance with s. 408.805, an applicant or
7 licensee shall pay a fee for each license application
8 submitted under this part, part II of chapter 408, and
9 applicable rules. With the exception of state-operated
10 licensed facilities, each facility licensed under this part
11 shall pay to the agency, at the time of inspection, the
12 following fees:
13 (a) Inspection for licensure.--A fee shall be paid
14 which is not less than $8 per hospital bed, nor more than $12
15 per hospital bed, except that the minimum fee shall be $400
16 per facility.
17 (b) Inspection for lifesafety only.--A fee shall be
18 paid which is not less than 75 cents per hospital bed, nor
19 more than $1.50 per hospital bed, except that the minimum fee
20 shall be $40 per facility.
21 (4) The agency shall coordinate all periodic
22 inspections for licensure made by the agency to ensure that
23 the cost to the facility of such inspections and the
24 disruption of services by such inspections is minimized.
25 Section 43. Section 395.0162, Florida Statutes, is
26 repealed.
27 Section 44. Subsections (2) and (3) of section
28 395.0163, Florida Statutes, are amended to read:
29 395.0163 Construction inspections; plan submission and
30 approval; fees.--
31
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1 (2)(a) The agency is authorized to charge an initial
2 fee of $2,000 for review of plans and construction on all
3 projects, no part of which is refundable. The agency may also
4 collect a fee, not to exceed 1 percent of the estimated
5 construction cost or the actual cost of review, whichever is
6 less, for the portion of the review which encompasses initial
7 review through the initial revised construction document
8 review. The agency is further authorized to collect its actual
9 costs on all subsequent portions of the review and
10 construction inspections. The initial fee payment shall
11 accompany the initial submission of plans and specifications.
12 Any subsequent payment that is due is payable upon receipt of
13 the invoice from the agency.
14 (b) Notwithstanding any other provisions of law to the
15 contrary, all moneys received by the agency pursuant to the
16 provisions of this section shall be deposited in the Planning
17 and Regulation Trust Fund, as created by s. 395.004, to be
18 held and applied solely for the operations required under this
19 section.
20 (3) In addition to the requirements of s. 408.811, the
21 agency shall inspect a mobile surgical facility at initial
22 licensure and at each time the facility establishes a new
23 location, prior to admission of patients. However, such
24 inspections shall not be required when a mobile surgical
25 facility is moved temporarily to a location where medical
26 treatment will not be provided.
27 Section 45. Subsection (6) of section 395.0193,
28 Florida Statutes, is amended to read:
29 395.0193 Licensed facilities; peer review;
30 disciplinary powers; agency or partnership with physicians.--
31
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1 (6) For a single incident or series of isolated
2 incidents that are nonwillful violations of the reporting
3 requirements of this section or part II of chapter 408, the
4 agency shall first seek to obtain corrective action by the
5 facility. If correction is not demonstrated within the
6 timeframe established by the agency or if there is a pattern
7 of nonwillful violations of this section or part II of chapter
8 408, the agency may impose an administrative fine, not to
9 exceed $5,000 for any violation of the reporting requirements
10 of this section or part II of chapter 408. The administrative
11 fine for repeated nonwillful violations may shall not exceed
12 $10,000 for any violation. The administrative fine for each
13 intentional and willful violation may not exceed $25,000 per
14 violation, per day. The fine for an intentional and willful
15 violation of this section or part II of chapter 408 may not
16 exceed $250,000. In determining the amount of fine to be
17 levied, the agency shall be guided by s. 395.1065(1)(2)(b).
18 Section 46. Subsection (12) of section 395.0197,
19 Florida Statutes, is amended to read:
20 395.0197 Internal risk management program.--
21 (12) In addition to any penalty imposed pursuant to
22 this section or part II of chapter 408, the agency shall
23 require a written plan of correction from the facility. For a
24 single incident or series of isolated incidents that are
25 nonwillful violations of the reporting requirements of this
26 section or part II of chapter 408, the agency shall first seek
27 to obtain corrective action by the facility. If the correction
28 is not demonstrated within the timeframe established by the
29 agency or if there is a pattern of nonwillful violations of
30 this section or part II of chapter 408, the agency may impose
31 an administrative fine, not to exceed $5,000 for any violation
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1 of the reporting requirements of this section or part II of
2 chapter 408. The administrative fine for repeated nonwillful
3 violations may shall not exceed $10,000 for any violation. The
4 administrative fine for each intentional and willful violation
5 may not exceed $25,000 per violation, per day. The fine for an
6 intentional and willful violation of this section or part II
7 of chapter 408 may not exceed $250,000. In determining the
8 amount of fine to be levied, the agency shall be guided by s.
9 395.1065(1)(2)(b).
10 Section 47. Section 395.0199, Florida Statutes, is
11 amended to read:
12 395.0199 Private utilization review.--
13 (1) The purpose of this section is to:
14 (a) Promote the delivery of quality health care in a
15 cost-effective manner.
16 (b) Foster greater coordination between providers and
17 health insurers performing utilization review.
18 (c) Protect patients and insurance providers by
19 ensuring that private review agents are qualified to perform
20 utilization review activities and to make informed decisions
21 on the appropriateness of medical care.
22 (d) This section does not regulate the activities of
23 private review agents, health insurers, health maintenance
24 organizations, or hospitals, except as expressly provided
25 herein, or authorize regulation or intervention as to the
26 correctness of utilization review decisions of insurers or
27 private review agents.
28 (2) The requirements of part II of chapter 408 apply
29 to the provision of services that require registration or
30 licensure pursuant to this section and part II of chapter 408
31 and to persons registered by or applying for such registration
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1 from the Agency for Health Care Administration pursuant to
2 this section. Registration or a license issued by the agency
3 is required in order to perform as a private review agent
4 conducting utilization review as to health care services in
5 this state performed or proposed to be performed in this state
6 shall register with the agency in accordance with this
7 section.
8 (3) In accordance with s. 408.805, an applicant for
9 registration or the registrant shall pay a fee for each
10 registration application submitted under this section, part II
11 of chapter 408, and applicable rules. The amount of the fee
12 shall be established by rule and Registration shall be made
13 annually with the agency on forms furnished by the agency and
14 shall be accompanied by the appropriate registration fee as
15 set by the agency. The fee shall be sufficient to pay for the
16 administrative costs of registering the agent, but may shall
17 not exceed $500 $250. The agency may also charge reasonable
18 fees, reflecting actual costs, to persons requesting copies of
19 registration.
20 (4) Each applicant for registration must comply with
21 the following requirements:
22 (a) Upon receipt of a completed, signed, and dated
23 application, the agency shall require background screening, in
24 accordance with the level 2 standards for screening set forth
25 in chapter 435, of the managing employee or other similarly
26 titled individual who is responsible for the operation of the
27 entity. The applicant must comply with the procedures for
28 level 2 background screening as set forth in chapter 435, as
29 well as the requirements of s. 435.03(3).
30 (b) The agency may require background screening of any
31 other individual who is an applicant, if the agency has
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1 probable cause to believe that he or she has been convicted of
2 a crime or has committed any other offense prohibited under
3 the level 2 standards for screening set forth in chapter 435.
4 (c) Proof of compliance with the level 2 background
5 screening requirements of chapter 435 which has been submitted
6 within the previous 5 years in compliance with any other
7 health care licensure requirements of this state is acceptable
8 in fulfillment of the requirements of paragraph (a).
9 (d) A provisional registration may be granted to an
10 applicant when each individual required by this section to
11 undergo background screening has met the standards for the
12 Department of Law Enforcement background check, but the agency
13 has not yet received background screening results from the
14 Federal Bureau of Investigation, or a request for a
15 disqualification exemption has been submitted to the agency as
16 set forth in chapter 435 but a response has not yet been
17 issued. A standard registration may be granted to the
18 applicant upon the agency's receipt of a report of the results
19 of the Federal Bureau of Investigation background screening
20 for each individual required by this section to undergo
21 background screening which confirms that all standards have
22 been met, or upon the granting of a disqualification exemption
23 by the agency as set forth in chapter 435. Any other person
24 who is required to undergo level 2 background screening may
25 serve in his or her capacity pending the agency's receipt of
26 the report from the Federal Bureau of Investigation. However,
27 the person may not continue to serve if the report indicates
28 any violation of background screening standards and a
29 disqualification exemption has not been requested of and
30 granted by the agency as set forth in chapter 435.
31
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1 (e) Each applicant must submit to the agency, with its
2 application, a description and explanation of any exclusions,
3 permanent suspensions, or terminations of the applicant from
4 the Medicare or Medicaid programs. Proof of compliance with
5 the requirements for disclosure of ownership and control
6 interests under the Medicaid or Medicare programs shall be
7 accepted in lieu of this submission.
8 (f) Each applicant must submit to the agency a
9 description and explanation of any conviction of an offense
10 prohibited under the level 2 standards of chapter 435 by a
11 member of the board of directors of the applicant, its
12 officers, or any individual owning 5 percent or more of the
13 applicant. This requirement does not apply to a director of a
14 not-for-profit corporation or organization if the director
15 serves solely in a voluntary capacity for the corporation or
16 organization, does not regularly take part in the day-to-day
17 operational decisions of the corporation or organization,
18 receives no remuneration for his or her services on the
19 corporation or organization's board of directors, and has no
20 financial interest and has no family members with a financial
21 interest in the corporation or organization, provided that the
22 director and the not-for-profit corporation or organization
23 include in the application a statement affirming that the
24 director's relationship to the corporation satisfies the
25 requirements of this paragraph.
26 (g) A registration may not be granted to an applicant
27 if the applicant or managing employee has been found guilty
28 of, regardless of adjudication, or has entered a plea of nolo
29 contendere or guilty to, any offense prohibited under the
30 level 2 standards for screening set forth in chapter 435,
31
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1 unless an exemption from disqualification has been granted by
2 the agency as set forth in chapter 435.
3 (h) The agency may deny or revoke the registration if
4 any applicant:
5 1. Has falsely represented a material fact in the
6 application required by paragraph (e) or paragraph (f), or has
7 omitted any material fact from the application required by
8 paragraph (e) or paragraph (f); or
9 2. Has had prior action taken against the applicant
10 under the Medicaid or Medicare program as set forth in
11 paragraph (e).
12 (i) An application for registration renewal must
13 contain the information required under paragraphs (e) and (f).
14 (4)(5) In addition to the requirements of part II of
15 chapter 408, registration shall include the following:
16 (a) A description of the review policies and
17 procedures to be used in evaluating proposed or delivered
18 hospital care.
19 (b) The name, address, and telephone number of the
20 utilization review agent performing utilization review, who
21 shall be at least:
22 1. A licensed practical nurse or licensed registered
23 nurse, or other similarly qualified medical records or health
24 care professionals, for performing initial review when
25 information is necessary from the physician or hospital to
26 determine the medical necessity or appropriateness of hospital
27 services; or
28 2. A licensed physician, or a licensed physician
29 practicing in the field of psychiatry for review of mental
30 health services, for an initial denial determination prior to
31 a final denial determination by the health insurer and which
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1 shall include the written evaluation and findings of the
2 reviewing physician.
3 (c) A description of an appeal procedure for patients
4 or health care providers whose services are under review, who
5 may appeal an initial denial determination prior to a final
6 determination by the health insurer with whom the private
7 review agent has contracted. The appeal procedure shall
8 provide for review by a licensed physician, or by a licensed
9 physician practicing in the field of psychiatry for review of
10 mental health services, and shall include the written
11 evaluation and findings of the reviewing physician.
12 (d) A designation of the times when the staff of the
13 utilization review agent will be available by toll-free
14 telephone, which shall include at least 40 hours per week
15 during the normal business hours of the agent.
16 (e) An acknowledgment and agreement that any private
17 review agent which, as a general business practice, fails to
18 adhere to the policies, procedures, and representations made
19 in its application for registration shall have its
20 registration revoked.
21 (f) Disclosure of any incentive payment provision or
22 quota provision which is contained in the agent's contract
23 with a health insurer and is based on reduction or denial of
24 services, reduction of length of stay, or selection of
25 treatment setting.
26 (g) Updates of any material changes to review policies
27 or procedures.
28 (6) The agency may impose fines or suspend or revoke
29 the registration of any private review agent in violation of
30 this section. Any private review agent failing to register or
31 update registration as required by this section shall be
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1 deemed to be within the jurisdiction of the agency and subject
2 to an administrative penalty not to exceed $1,000. The agency
3 may bring actions to enjoin activities of private review
4 agents in violation of this section.
5 (5)(7) No insurer shall knowingly contract with or
6 utilize a private review agent which has failed to register as
7 required by this section or which has had a registration
8 revoked by the agency.
9 (6)(8) A private review agent which operates under
10 contract with the federal or state government for utilization
11 review of patients eligible for hospital or other services
12 under Title XVIII or Title XIX of the Social Security Act is
13 exempt from the provisions of this section for services
14 provided under such contract. A private review agent which
15 provides utilization review services to the federal or state
16 government and a private insurer shall not be exempt for
17 services provided to nonfederally funded patients. This
18 section shall not apply to persons who perform utilization
19 review services for medically necessary hospital services
20 provided to injured workers pursuant to chapter 440 and shall
21 not apply to self-insurance funds or service companies
22 authorized pursuant to chapter 440 or part VII of chapter 626.
23 (7)(9) Facilities licensed under this chapter shall
24 promptly comply with the requests of utilization review agents
25 or insurers which are reasonably necessary to facilitate
26 prompt accomplishment of utilization review activities.
27 (8)(10) The agency shall adopt rules to implement the
28 provisions of this section.
29 Section 48. Subsection (1) of section 395.1046,
30 Florida Statutes, is amended to read:
31 395.1046 Complaint investigation procedures.--
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1 (1) In addition to the requirements of s. 408.811, the
2 agency shall investigate any complaint against a hospital for
3 any violation of s. 395.1041 which that the agency reasonably
4 believes to be legally sufficient. A complaint is legally
5 sufficient if it contains ultimate facts showing which show
6 that a violation of this chapter, or any rule adopted under
7 this chapter by the agency, has occurred. The agency may
8 investigate, or continue to investigate, and may take
9 appropriate final action on a complaint, even though the
10 original complainant withdraws his or her complaint or
11 otherwise indicates his or her desire not to cause it to be
12 investigated to completion. When an investigation of any
13 person or facility is undertaken, the agency shall notify such
14 person in writing of the investigation and inform the person
15 or facility in writing of the substance, the facts showing
16 which show that a violation has occurred, and the source of
17 any complaint filed against him or her. The agency may conduct
18 an investigation without notification to any person if the act
19 under investigation is a criminal offense. The agency shall
20 have access to all records necessary for the investigation of
21 the complaint.
22 Section 49. Paragraph (f) of subsection (1) of section
23 395.1055, Florida Statutes, is amended, and subsection (9) is
24 added to that section, to read:
25 395.1055 Rules and enforcement.--
26 (1) The agency shall adopt rules pursuant to ss.
27 120.536(1) and 120.54 to implement the provisions of this
28 part, which shall include reasonable and fair minimum
29 standards for ensuring that:
30 (f) All hospitals submit such data as necessary to
31 conduct certificate-of-need reviews required under part I of
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1 chapter 408 ss. 408.031-408.045. Such data shall include, but
2 shall not be limited to, patient origin data, hospital
3 utilization data, type of service reporting, and facility
4 staffing data. The agency may shall not collect data that
5 identifies or could disclose the identity of individual
6 patients. The agency shall utilize existing uniform statewide
7 data sources when available and shall minimize reporting costs
8 to hospitals.
9 (9) The agency may adopt rules to administer the
10 requirements of part II of chapter 408.
11 Section 50. Section 395.1065, Florida Statutes, is
12 amended to read:
13 395.1065 Criminal and administrative penalties;
14 injunctions; emergency orders; moratorium.--
15 (1) In addition to s. 408.812, any person
16 establishing, conducting, managing, or operating any facility
17 without a license under this part commits is guilty of a
18 misdemeanor and, upon conviction, shall be fined not more than
19 $500 for the first offense and not more than $1,000 for each
20 subsequent offense, and each day of continuing violation after
21 conviction shall be considered a separate offense.
22 (2)(a) The agency may deny, revoke, or suspend a
23 license or impose an administrative fine, not to exceed $1,000
24 per violation, per day, for the violation of any provision of
25 this part, part II of chapter 408, or applicable rules adopted
26 under this part. Each day of violation constitutes a separate
27 violation and is subject to a separate fine.
28 (b) In determining the amount of fine to be levied for
29 a violation, as provided in paragraph (a), the following
30 factors shall be considered:
31
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1 1. The severity of the violation, including the
2 probability that death or serious harm to the health or safety
3 of any person will result or has resulted, the severity of the
4 actual or potential harm, and the extent to which the
5 provisions of this part were violated.
6 2. Actions taken by the licensee to correct the
7 violations or to remedy complaints.
8 3. Any previous violations of the licensee.
9 (c) All amounts collected pursuant to this section
10 shall be deposited into the Planning and Regulation Trust
11 Fund, as created by s. 395.004.
12 (c)(d) The agency may impose an administrative fine
13 for the violation of s. 641.3154 or, if sufficient claims due
14 to a provider from a health maintenance organization do not
15 exist to enable the take-back of an overpayment, as provided
16 under s. 641.3155(5), for the violation of s. 641.3155(5). The
17 administrative fine for a violation cited in this paragraph
18 shall be in the amounts specified in s. 641.52(5), and the
19 provisions of paragraph (a) do not apply.
20 (3) Notwithstanding the existence or pursuit of any
21 other remedy, the agency may maintain an action in the name of
22 the state for injunction or other process to enforce the
23 provisions of this part and rules promulgated hereunder.
24 (4) The agency may issue an emergency order
25 immediately suspending or revoking a license when it
26 determines that any condition in the licensed facility
27 presents a clear and present danger to public health and
28 safety.
29 (3)(5) In accordance with part II of chapter 408, the
30 agency may impose an immediate moratorium on elective
31 admissions to any licensed facility, building, or portion
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1 thereof, or service, when the agency determines that any
2 condition in the facility presents a threat to public health
3 or safety.
4 (4)(6) In seeking to impose penalties against a
5 facility as defined in s. 394.455 for a violation of part I of
6 chapter 394, the agency is authorized to rely on the
7 investigation and findings by the Department of Health in lieu
8 of conducting its own investigation.
9 (5)(7) The agency shall impose a fine of $500 for each
10 instance of the facility's failure to provide the information
11 required by rules adopted pursuant to s. 395.1055(1)(h).
12 Section 51. Subsections (1) and (8) of section
13 395.10973, Florida Statutes, are amended to read:
14 395.10973 Powers and duties of the agency.--It is the
15 function of the agency to:
16 (1) Adopt rules pursuant to ss. 120.536(1) and 120.54
17 to implement the provisions of this part and part II of
18 chapter 408 conferring duties upon it.
19 (8) Enforce the special-occupancy provisions of the
20 Florida Building Code which apply to hospitals, intermediate
21 residential treatment facilities, and ambulatory surgical
22 centers in conducting any inspection authorized by this
23 chapter and part II of chapter 408.
24 Section 52. Section 395.10974, Florida Statutes, is
25 amended to read:
26 395.10974 Health care risk managers; qualifications,
27 licensure, fees.--
28 (1) The requirements of part II of chapter 408 apply
29 to the provision of services that require licensure pursuant
30 to ss. 395.10971-395.10975, and part II of chapter 408 and to
31 entities licensed by or applying for such licensure from the
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1 Agency for Health Care Administration pursuant to ss.
2 395.10971-395.10975. A license issued by the agency is
3 required in order to perform as a health care risk manager in
4 this state. Any person desiring to be licensed as a health
5 care risk manager shall submit an application on a form
6 provided by the agency. In order to qualify for licensure, the
7 applicant shall submit evidence satisfactory to the agency
8 which demonstrates the applicant's competence, by education or
9 experience, in the following areas:
10 (a) Applicable standards of health care risk
11 management.
12 (b) Applicable federal, state, and local health and
13 safety laws and rules.
14 (c) General risk management administration.
15 (d) Patient care.
16 (e) Medical care.
17 (f) Personal and social care.
18 (g) Accident prevention.
19 (h) Departmental organization and management.
20 (i) Community interrelationships.
21 (j) Medical terminology.
22
23 Each applicant for licensure and each licensee must comply
24 with all provisions of part II of chapter 408. The agency may
25 require such additional information, from the applicant or any
26 other person, as may be reasonably required to verify the
27 information contained in the application.
28 (2) The agency shall not grant or issue a license as a
29 health care risk manager to any individual unless from the
30 application it affirmatively appears that the applicant:
31 (a) Is 18 years of age or over;
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1 (b) Is a high school graduate or equivalent; and
2 (c)1. Has fulfilled the requirements of a 1-year
3 program or its equivalent in health care risk management
4 training which may be developed or approved by the agency;
5 2. Has completed 2 years of college-level studies
6 which would prepare the applicant for health care risk
7 management, to be further defined by rule; or
8 3. Has obtained 1 year of practical experience in
9 health care risk management.
10 (3) The agency shall issue a license to practice
11 health care risk management to any applicant who qualifies
12 under this section. In accordance with s. 408.805, an
13 applicant or licensee shall pay a fee for each license
14 application submitted under this part, part II of chapter 408,
15 and applicable rules. The amount of the fee shall be
16 established by rule as follows: and submits an application fee
17 of not more than $75, a background-screening fingerprinting
18 fee of not more than $75, and a license fee of not more than
19 $100. The agency shall by rule establish fees and procedures
20 for the issuance and cancellation of licenses.
21 (4) The agency shall renew a health care risk manager
22 license upon receipt of a biennial renewal application and
23 fees. The agency shall by rule establish a procedure for the
24 biennial renewal of licenses.
25 Section 53. Paragraph (c) of subsection (2) of section
26 395.602, Florida Statutes, is amended to read:
27 395.602 Rural hospitals.--
28 (2) DEFINITIONS.--As used in this part:
29 (c) "Inactive rural hospital bed" means a licensed
30 acute care hospital bed, as defined in s. 395.002(13)(14),
31
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1 that is inactive in that it cannot be occupied by acute care
2 inpatients.
3 Section 54. Paragraph (c) of subsection (1) of section
4 395.701, Florida Statutes, is amended to read:
5 395.701 Annual assessments on net operating revenues
6 for inpatient and outpatient services to fund public medical
7 assistance; administrative fines for failure to pay
8 assessments when due; exemption.--
9 (1) For the purposes of this section, the term:
10 (c) "Hospital" means a health care institution as
11 defined in s. 395.002(12)(13), but does not include any
12 hospital operated by the agency or the Department of
13 Corrections.
14 Section 55. Subsection (4) of section 400.0073,
15 Florida Statutes, is amended to read:
16 400.0073 State and local ombudsman council
17 investigations.--
18 (4) If the ombudsman or any state or local council
19 member is not allowed to enter a long-term care facility, the
20 administrator of the facility shall be considered to have
21 interfered with a representative of the office, the state
22 council, or the local council in the performance of official
23 duties as described in s. 400.0083(1) and to have committed a
24 violation of this part. The ombudsman shall report a
25 facility's refusal to allow entry to the agency, and the
26 agency shall record the report and take it into consideration
27 when determining actions allowable under s. 400.102, s.
28 400.121, s. 429.14 400.414, s. 429.19 400.419, s. 429.69
29 400.6194, or s.429.71 400.6196.
30 Section 56. Subsection (4) of section 400.0074,
31 Florida Statutes, is amended to read:
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1 400.0074 Local ombudsman council onsite administrative
2 assessments.--
3 (4) An onsite administrative assessment may not be
4 accomplished by forcible entry. However, if the ombudsman or a
5 state or local council member is not allowed to enter a
6 long-term care facility, the administrator of the facility
7 shall be considered to have interfered with a representative
8 of the office, the state council, or the local council in the
9 performance of official duties as described in s. 400.0083(1)
10 and to have committed a violation of this part. The ombudsman
11 shall report the refusal by a facility to allow entry to the
12 agency, and the agency shall record the report and take it
13 into consideration when determining actions allowable under s.
14 429.14 400.414, s. 429.19 400.419, s. 429.69 400.6194, or s.
15 429.71 400.6196.
16 Section 57. Subsections (6) through (19) of section
17 400.021, Florida Statutes, are renumbered as subsections (5)
18 through (18), respectively, and present subsections (5) and
19 (20) of that section are amended to read:
20 400.021 Definitions.--When used in this part, unless
21 the context otherwise requires, the term:
22 (5) "Controlling interest" means:
23 (a) The applicant for licensure or a licensee;
24 (b) A person or entity that serves as an officer of,
25 is on the board of directors of, or has a 5 percent or greater
26 ownership interest in the management company or other entity,
27 related or unrelated, which the applicant or licensee may
28 contract with to operate the facility; or
29 (c) A person or entity that serves as an officer of,
30 is on the board of directors of, or has a 5 percent or greater
31 ownership interest in the applicant or licensee.
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1
2 The term does not include a voluntary board member.
3 (20) "Voluntary board member" means a director of a
4 not-for-profit corporation or organization who serves solely
5 in a voluntary capacity for the corporation or organization,
6 does not receive any remuneration for his or her services on
7 the board of directors, and has no financial interest in the
8 corporation or organization. The agency shall recognize a
9 person as a voluntary board member following submission of a
10 statement to the agency by the director and the not-for-profit
11 corporation or organization which affirms that the director
12 conforms to this definition. The statement affirming the
13 status of the director must be submitted to the agency on a
14 form provided by the agency.
15 Section 58. Subsection (3) of section 400.022, Florida
16 Statutes, is amended to read:
17 400.022 Residents' rights.--
18 (3) Any violation of the resident's rights set forth
19 in this section shall constitute grounds for action by the
20 agency under the provisions of s. 400.102, s. 400.121, or part
21 II of chapter 408. In order to determine whether the licensee
22 is adequately protecting residents' rights, the licensure
23 annual inspection of the facility shall include private
24 informal conversations with a sample of residents to discuss
25 residents' experiences within the facility with respect to
26 rights specified in this section and general compliance with
27 standards, and consultation with the ombudsman council in the
28 local planning and service area of the Department of Elderly
29 Affairs in which the nursing home is located.
30 Section 59. Paragraph (b) of subsection (1) of section
31 400.051, Florida Statutes, is amended to read:
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1 400.051 Homes or institutions exempt from the
2 provisions of this part.--
3 (1) The following shall be exempt from the provisions
4 of this part:
5 (b) Any hospital, as defined in s. 395.002(11), that
6 is licensed under chapter 395.
7 Section 60. Section 400.062, Florida Statutes, is
8 amended to read:
9 400.062 License required; fee; disposition; display;
10 transfer.--
11 (1) The requirements of part II of chapter 408 apply
12 to the provision of services that require licensure pursuant
13 to this part and part II of chapter 408 and to entities
14 licensed by or applying for such licensure from the Agency for
15 Health Care Administration pursuant to this part. A license
16 issued by the agency is required for the operation of a
17 nursing home in this state. It is unlawful to operate or
18 maintain a facility without first obtaining from the agency a
19 license authorizing such operation.
20 (2) Separate licenses shall be required for facilities
21 maintained in separate premises, even though operated under
22 the same management. However, a separate license shall not be
23 required for separate buildings on the same grounds.
24 (3) In accordance with s. 408.805, an applicant or
25 licensee shall pay a fee for each license application
26 submitted under this part, part II of chapter 408, and
27 applicable rules. The annual license fee required for each
28 license issued under this part shall be comprised of two
29 parts. Part I of the license fee shall be the basic license
30 fee. The rate per bed for the basic license fee shall be
31 established biennially annually and shall be $100 $50 per bed
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1 unless modified by rule. The agency may adjust the per bed
2 licensure fees by the Consumer Price Index based on the 12
3 months immediately preceding the increase to cover the cost of
4 regulation under this part. Part II of the license fee shall
5 be the resident protection fee, which shall be at the rate of
6 not less than 50 25 cents per bed. The rate per bed shall be
7 the minimum rate per bed, and such rate shall remain in effect
8 until the effective date of a rate per bed adopted by rule by
9 the agency pursuant to this part. At such time as the amount
10 on deposit in the Resident Protection Trust Fund is less than
11 $1 million, the agency may adopt rules to establish a rate
12 which may not exceed $20 $10 per bed. The rate per bed shall
13 revert back to the minimum rate per bed when the amount on
14 deposit in the Resident Protection Trust Fund reaches $1
15 million, except that any rate established by rule shall remain
16 in effect until such time as the rate has been equally
17 required for each license issued under this part. Any amount
18 in the fund in excess of $2 million shall revert to the Health
19 Care Trust Fund and may not be expended without prior approval
20 of the Legislature. The agency may prorate the biennial annual
21 license fee for those licenses which it issues under this part
22 for less than 2 years 1 year. Funds generated by license fees
23 collected in accordance with this section shall be deposited
24 in the following manner:
25 (a) The basic license fee collected shall be deposited
26 in the Health Care Trust Fund, established for the sole
27 purpose of carrying out this part. When the balance of the
28 account established in the Health Care Trust Fund for the
29 deposit of fees collected as authorized under this section
30 exceeds one-third of the annual cost of regulation under this
31
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1 part, the excess shall be used to reduce the licensure fees in
2 the next year.
3 (b) The resident protection fee collected shall be
4 deposited in the Resident Protection Trust Fund for the sole
5 purpose of paying, in accordance with the provisions of s.
6 400.063, for the appropriate alternate placement, care, and
7 treatment of a resident removed from a nursing home facility
8 on a temporary, emergency basis or for the maintenance and
9 care of residents in a nursing home facility pending removal
10 and alternate placement.
11 (4) Counties or municipalities applying for licenses
12 under this part are exempt from license fees authorized under
13 this section.
14 (5) The license shall be displayed in a conspicuous
15 place inside the facility.
16 (6) A license shall be valid only in the hands of the
17 individual, firm, partnership, association, or corporation to
18 whom it is issued and shall not be subject to sale,
19 assignment, or other transfer, voluntary or involuntary, nor
20 shall a license be valid for any premises other than those for
21 which originally issued.
22 Section 61. Subsection (1) of section 400.063, Florida
23 Statutes, is amended to read:
24 400.063 Resident Protection Trust Fund.--
25 (1) A Resident Protection Trust Fund shall be
26 established for the purpose of collecting and disbursing funds
27 generated from the license fees and administrative fines as
28 provided for in ss. 393.0673(2), 400.062(3)(b), 400.111(1),
29 400.121(2), and 400.23(8). Such funds shall be for the sole
30 purpose of paying for the appropriate alternate placement,
31 care, and treatment of residents who are removed from a
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1 facility licensed under this part or a facility specified in
2 s. 393.0678(1) in which the agency determines that existing
3 conditions or practices constitute an immediate danger to the
4 health, safety, or security of the residents. If the agency
5 determines that it is in the best interest of the health,
6 safety, or security of the residents to provide for an orderly
7 removal of the residents from the facility, the agency may
8 utilize such funds to maintain and care for the residents in
9 the facility pending removal and alternative placement. The
10 maintenance and care of the residents shall be under the
11 direction and control of a receiver appointed pursuant to s.
12 393.0678(1) or s. 400.126(1). However, funds may be expended
13 in an emergency upon a filing of a petition for a receiver,
14 upon the declaration of a state of local emergency pursuant to
15 s. 252.38(3)(a)5., or upon a duly authorized local order of
16 evacuation of a facility by emergency personnel to protect the
17 health and safety of the residents.
18 Section 62. Section 400.071, Florida Statutes, is
19 amended to read:
20 400.071 Application for license.--
21 (1) An application for a license as required by s.
22 400.062 shall be made to the agency on forms furnished by it
23 and shall be accompanied by the appropriate license fee.
24 (1)(2) In addition to the requirements of part II of
25 chapter 408, the application for a license shall be under oath
26 and must shall contain the following:
27 (a) The name, address, and social security number of
28 the applicant if an individual; if the applicant is a firm,
29 partnership, or association, its name, address, and employer
30 identification number (EIN), and the name and address of any
31
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1 controlling interest; and the name by which the facility is to
2 be known.
3 (b) The name of any person whose name is required on
4 the application under the provisions of paragraph (a) and who
5 owns at least a 10-percent interest in any professional
6 service, firm, association, partnership, or corporation
7 providing goods, leases, or services to the facility for which
8 the application is made, and the name and address of the
9 professional service, firm, association, partnership, or
10 corporation in which such interest is held.
11 (a)(c) The location of the facility for which a
12 license is sought and an indication, as in the original
13 application, that such location conforms to the local zoning
14 ordinances.
15 (d) The name of the person or persons under whose
16 management or supervision the facility will be conducted and
17 the name of the administrator.
18 (b)(e) A signed affidavit disclosing any financial or
19 ownership interest that a controlling interest as defined in
20 part II of chapter 408 person or entity described in paragraph
21 (a) or paragraph (d) has held in the last 5 years in any
22 entity licensed by this state or any other state to provide
23 health or residential care which has closed voluntarily or
24 involuntarily; has filed for bankruptcy; has had a receiver
25 appointed; has had a license denied, suspended, or revoked; or
26 has had an injunction issued against it which was initiated by
27 a regulatory agency. The affidavit must disclose the reason
28 any such entity was closed, whether voluntarily or
29 involuntarily.
30 (c)(f) The total number of beds and the total number
31 of Medicare and Medicaid certified beds.
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1 (d)(g) Information relating to the number, experience,
2 and training of the employees of the facility and of the moral
3 character of the applicant and employees which the agency
4 requires by rule, including the name and address of any
5 nursing home with which the applicant or employees have been
6 affiliated through ownership or employment within 5 years of
7 the date of the application for a license and the record of
8 any criminal convictions involving the applicant and any
9 criminal convictions involving an employee if known by the
10 applicant after inquiring of the employee. The applicant must
11 demonstrate that sufficient numbers of qualified staff, by
12 training or experience, will be employed to properly care for
13 the type and number of residents who will reside in the
14 facility.
15 (e)(h) Copies of any civil verdict or judgment
16 involving the applicant rendered within the 10 years preceding
17 the application, relating to medical negligence, violation of
18 residents' rights, or wrongful death. As a condition of
19 licensure, the licensee agrees to provide to the agency copies
20 of any new verdict or judgment involving the applicant,
21 relating to such matters, within 30 days after filing with the
22 clerk of the court. The information required in this paragraph
23 shall be maintained in the facility's licensure file and in an
24 agency database which is available as a public record.
25 (3) The applicant shall submit evidence which
26 establishes the good moral character of the applicant,
27 manager, supervisor, and administrator. No applicant, if the
28 applicant is an individual; no member of a board of directors
29 or officer of an applicant, if the applicant is a firm,
30 partnership, association, or corporation; and no licensed
31 nursing home administrator shall have been convicted, or found
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1 guilty, regardless of adjudication, of a crime in any
2 jurisdiction which affects or may potentially affect residents
3 in the facility.
4 (4) Each applicant for licensure must comply with the
5 following requirements:
6 (a) Upon receipt of a completed, signed, and dated
7 application, the agency shall require background screening of
8 the applicant, in accordance with the level 2 standards for
9 screening set forth in chapter 435. As used in this
10 subsection, the term "applicant" means the facility
11 administrator, or similarly titled individual who is
12 responsible for the day-to-day operation of the licensed
13 facility, and the facility financial officer, or similarly
14 titled individual who is responsible for the financial
15 operation of the licensed facility.
16 (b) The agency may require background screening for a
17 member of the board of directors of the licensee or an officer
18 or an individual owning 5 percent or more of the licensee if
19 the agency has probable cause to believe that such individual
20 has been convicted of an offense prohibited under the level 2
21 standards for screening set forth in chapter 435.
22 (c) Proof of compliance with the level 2 background
23 screening requirements of chapter 435 which has been submitted
24 within the previous 5 years in compliance with any other
25 health care or assisted living licensure requirements of this
26 state is acceptable in fulfillment of paragraph (a). Proof of
27 compliance with background screening which has been submitted
28 within the previous 5 years to fulfill the requirements of the
29 Financial Services Commission and the Office of Insurance
30 Regulation pursuant to chapter 651 as part of an application
31 for a certificate of authority to operate a continuing care
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1 retirement community is acceptable in fulfillment of the
2 Department of Law Enforcement and Federal Bureau of
3 Investigation background check.
4 (d) A provisional license may be granted to an
5 applicant when each individual required by this section to
6 undergo background screening has met the standards for the
7 Department of Law Enforcement background check, but the agency
8 has not yet received background screening results from the
9 Federal Bureau of Investigation, or a request for a
10 disqualification exemption has been submitted to the agency as
11 set forth in chapter 435, but a response has not yet been
12 issued. A license may be granted to the applicant upon the
13 agency's receipt of a report of the results of the Federal
14 Bureau of Investigation background screening for each
15 individual required by this section to undergo background
16 screening which confirms that all standards have been met, or
17 upon the granting of a disqualification exemption by the
18 agency as set forth in chapter 435. Any other person who is
19 required to undergo level 2 background screening may serve in
20 his or her capacity pending the agency's receipt of the report
21 from the Federal Bureau of Investigation; however, the person
22 may not continue to serve if the report indicates any
23 violation of background screening standards and a
24 disqualification exemption has not been requested of and
25 granted by the agency as set forth in chapter 435.
26 (e) Each applicant must submit to the agency, with its
27 application, a description and explanation of any exclusions,
28 permanent suspensions, or terminations of the applicant from
29 the Medicare or Medicaid programs. Proof of compliance with
30 disclosure of ownership and control interest requirements of
31
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1 the Medicaid or Medicare programs shall be accepted in lieu of
2 this submission.
3 (f) Each applicant must submit to the agency a
4 description and explanation of any conviction of an offense
5 prohibited under the level 2 standards of chapter 435 by a
6 member of the board of directors of the applicant, its
7 officers, or any individual owning 5 percent or more of the
8 applicant. This requirement shall not apply to a director of a
9 not-for-profit corporation or organization if the director
10 serves solely in a voluntary capacity for the corporation or
11 organization, does not regularly take part in the day-to-day
12 operational decisions of the corporation or organization,
13 receives no remuneration for his or her services on the
14 corporation or organization's board of directors, and has no
15 financial interest and has no family members with a financial
16 interest in the corporation or organization, provided that the
17 director and the not-for-profit corporation or organization
18 include in the application a statement affirming that the
19 director's relationship to the corporation satisfies the
20 requirements of this paragraph.
21 (g) An application for license renewal must contain
22 the information required under paragraphs (e) and (f).
23 (5) The applicant shall furnish satisfactory proof of
24 financial ability to operate and conduct the nursing home in
25 accordance with the requirements of this part and all rules
26 adopted under this part, and the agency shall establish
27 standards for this purpose, including information reported
28 under paragraph (2)(e). The agency also shall establish
29 documentation requirements, to be completed by each applicant,
30 that show anticipated facility revenues and expenditures, the
31 basis for financing the anticipated cash-flow requirements of
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1 the facility, and an applicant's access to contingency
2 financing.
3 (6) If the applicant offers continuing care agreements
4 as defined in chapter 651, proof shall be furnished that such
5 applicant has obtained a certificate of authority as required
6 for operation under that chapter.
7 (2)(7) As a condition of licensure, each licensee,
8 except one offering continuing care agreements as defined in
9 chapter 651, must agree to accept recipients of Title XIX of
10 the Social Security Act on a temporary, emergency basis. The
11 persons whom the agency may require such licensees to accept
12 are those recipients of Title XIX of the Social Security Act
13 who are residing in a facility in which existing conditions
14 constitute an immediate danger to the health, safety, or
15 security of the residents of the facility.
16 (3)(8) The agency may not issue a license to a nursing
17 home that fails to receive a certificate of need under the
18 provisions of ss. 408.031-408.045. It is the intent of the
19 Legislature that, in reviewing a certificate-of-need
20 application to add beds to an existing nursing home facility,
21 preference be given to the application of a licensee who has
22 been awarded a Gold Seal as provided for in s. 400.235, if the
23 applicant otherwise meets the review criteria specified in s.
24 408.035.
25 (4)(9) The agency may develop an abbreviated survey
26 for licensure renewal applicable to a licensee that has
27 continuously operated as a nursing facility since 1991 or
28 earlier, has operated under the same management for at least
29 the preceding 30 months, and has had during the preceding 30
30 months no class I or class II deficiencies.
31
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1 (5)(10) As a condition of licensure, each facility
2 must establish and submit with its application a plan for
3 quality assurance and for conducting risk management.
4 (11) The applicant must provide the agency with proof
5 of a legal right to occupy the property before a license may
6 be issued. Proof may include, but is not limited to, copies of
7 warranty deeds, lease or rental agreements, contracts for
8 deeds, or quitclaim deeds.
9 Section 63. Section 400.0712, Florida Statutes, is
10 amended to read:
11 400.0712 Application for inactive license.--
12 (1) As specified in s. 408.321(4) and this section,
13 the agency may issue an inactive license to a nursing home
14 facility for all or a portion of its beds. Any request by a
15 licensee that a nursing home or portion of a nursing home
16 become inactive must be submitted to the agency in the
17 approved format. The facility may not initiate any suspension
18 of services, notify residents, or initiate inactivity facility
19 closure before receiving approval from the agency; and a
20 licensee facility that violates this provision may shall not
21 be issued an inactive license. Upon agency approval of an
22 inactive license, the nursing home shall notify residents of
23 any necessary discharge or transfer as provided in s.
24 400.0255.
25 (2) The agency may issue an inactive license to a
26 nursing home that chooses to use an unoccupied contiguous
27 portion of the facility for an alternative use to meet the
28 needs of elderly persons through the use of less restrictive,
29 less institutional services.
30 (a) An inactive license issued under this subsection
31 may be granted for a period not to exceed the current
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1 licensure expiration date 12 months but may be renewed
2 annually by the agency at the time of licensure renewal for 12
3 months.
4 (b) A request to extend the inactive license must be
5 submitted to the agency in the approved format and approved by
6 the agency in writing.
7 (c) Nursing homes that receive an inactive license to
8 provide alternative services shall not receive preference for
9 participation in the Assisted Living for the Elderly Medicaid
10 waiver.
11 (3) The agency may issue an inactive license to a
12 nursing home that will be temporarily unable to provide
13 services but is reasonably expected to resume services.
14 (a) An inactive license issued under this subsection
15 may be issued for a period not to exceed 12 months and may be
16 renewed by the agency for an additional 6 months upon
17 demonstration of progress toward reopening.
18 (b) All licensure fees must be current and paid in
19 full, and may be prorated as provided by agency rule, before
20 the inactive license is issued.
21 (c) Reactivation of an inactive license requires that
22 the applicant pay all licensure fees and be inspected by the
23 agency to confirm that all of the requirements of this part
24 and applicable rules are met.
25 (3)(4) The agency shall adopt rules pursuant to ss.
26 120.536(1) and 120.54 necessary to implement this section.
27 Section 64. Section 400.102, Florida Statutes, is
28 amended to read:
29 400.102 Action by agency against licensee; grounds.--
30
31
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1 (1) In addition to the grounds listed in part II of
2 chapter 408, any of the following conditions shall be grounds
3 for action by the agency against a licensee:
4 (1)(a) An intentional or negligent act materially
5 affecting the health or safety of residents of the facility;
6 (2)(b) Misappropriation or conversion of the property
7 of a resident of the facility;
8 (3)(c) Failure to follow the criteria and procedures
9 provided under part I of chapter 394 relating to the
10 transportation, voluntary admission, and involuntary
11 examination of a nursing home resident; or
12 (d) Violation of provisions of this part or rules
13 adopted under this part;
14 (4)(e) Fraudulent altering, defacing, or falsifying
15 any medical or nursing home records, or causing or procuring
16 any of these offenses to be committed. ; or
17 (f) Any act constituting a ground upon which
18 application for a license may be denied.
19 (2) If the agency has reasonable belief that any of
20 such conditions exist, it shall take the following action:
21 (a) In the case of an applicant for original
22 licensure, denial action as provided in s. 400.121.
23 (b) In the case of an applicant for relicensure or a
24 current licensee, administrative action as provided in s.
25 400.121 or injunctive action as authorized by s. 400.125.
26 (c) In the case of a facility operating without a
27 license, injunctive action as authorized in s. 400.125.
28 Section 65. Section 400.111, Florida Statutes, is
29 amended to read:
30 400.111 Disclosure of controlling interest Expiration
31 of license; renewal.--
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1 (1) A license issued for the operation of a facility,
2 unless sooner suspended or revoked, shall expire on the date
3 set forth by the agency on the face of the license or 1 year
4 from the date of issuance, whichever occurs first. Ninety days
5 prior to the expiration date, an application for renewal shall
6 be submitted to the agency. A license shall be renewed upon
7 the filing of an application on forms furnished by the agency
8 if the applicant has first met the requirements established
9 under this part and all rules adopted under this part. The
10 failure to file an application within the period established
11 in this subsection shall result in a late fee charged to the
12 licensee by the agency in an amount equal to 50 percent of the
13 fee in effect on the last preceding regular renewal date. A
14 late fee shall be levied for each and every day the filing of
15 the license application is delayed, but in no event shall such
16 fine aggregate more than $5,000. If an application is received
17 after the required filing date and exhibits a hand-canceled
18 postmark obtained from a United States Post Office dated on or
19 before the required filing date, no fine will be levied.
20 (2) A licensee against whom a revocation or suspension
21 proceeding, or any judicial proceeding instituted by the
22 agency under this part, is pending at the time of license
23 renewal may be issued a temporary license effective until
24 final disposition by the agency of such proceeding. If
25 judicial relief is sought from the aforesaid administrative
26 order, the court having jurisdiction may issue such orders
27 regarding the issuance of a temporary permit during the
28 pendency of the judicial proceeding.
29 (3) The agency may not renew a license if the
30 applicant has failed to pay any fines assessed by final order
31 of the agency or final order of the Health Care Financing
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1 Administration under requirements for federal certification.
2 The agency may renew the license of an applicant following the
3 assessment of a fine by final order if such fine has been paid
4 into an escrow account pending an appeal of a final order.
5 (4) In addition to the requirements of part II of
6 chapter 408, the licensee shall submit a signed affidavit
7 disclosing any financial or ownership interest that a
8 controlling interest licensee has held within the last 5 years
9 in any entity licensed by the state or any other state to
10 provide health or residential care which entity has closed
11 voluntarily or involuntarily; has filed for bankruptcy; has
12 had a receiver appointed; has had a license denied, suspended,
13 or revoked; or has had an injunction issued against it which
14 was initiated by a regulatory agency. The affidavit must
15 disclose the reason such entity was closed, whether
16 voluntarily or involuntarily.
17 Section 66. Subsections (2) and (5) of section
18 400.1183, Florida Statutes, are amended to read:
19 400.1183 Resident grievance procedures.--
20 (2) Each facility shall maintain records of all
21 grievances and shall report annually to the agency at the time
22 of relicensure the total number of grievances handled during
23 the prior licensure period, a categorization of the cases
24 underlying the grievances, and the final disposition of the
25 grievances.
26 (5) The agency may impose an administrative fine, in
27 accordance with s. 400.121, against a nursing home facility
28 for noncompliance with this section.
29 Section 67. Section 400.121, Florida Statutes, is
30 amended to read:
31
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1 400.121 Denial, suspension, revocation of license;
2 moratorium on admissions; administrative fines; procedure;
3 order to increase staffing.--
4 (1) The agency may deny an application, revoke or
5 suspend a license, and or impose an administrative fine, not
6 to exceed $500 per violation per day for the violation of any
7 provision of this part, part II of chapter 408, or applicable
8 rules, against any applicant or licensee for the following
9 violations by the applicant, licensee, or other controlling
10 interest:
11 (a) A violation of any provision of this part, part II
12 of chapter 408, or applicable rules s. 400.102(1); or
13 (b) A demonstrated pattern of deficient practice;
14 (c) Failure to pay any outstanding fines assessed by
15 final order of the agency or final order of the Health Care
16 Financing Administration pursuant to requirements for federal
17 certification. The agency may renew or approve the license of
18 an applicant following the assessment of a fine by final order
19 if such fine has been paid into an escrow account pending an
20 appeal of a final order;
21 (d) Exclusion from the Medicare or Medicaid program;
22 or
23 (b)(e) An adverse action by a regulatory agency
24 against any other licensed facility that has a common
25 controlling interest with the licensee or applicant against
26 whom the action under this section is being brought. If the
27 adverse action involves solely the management company, the
28 applicant or licensee shall be given 30 days to remedy before
29 final action is taken. If the adverse action is based solely
30 upon actions by a controlling interest, the applicant or
31 licensee may present factors in mitigation of any proposed
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1 penalty based upon a showing that such penalty is
2 inappropriate under the circumstances.
3
4 All hearings shall be held within the county in which the
5 licensee or applicant operates or applies for a license to
6 operate a facility as defined herein.
7 (2) Except as provided in s. 400.23(8), a $500 fine
8 shall be imposed for each violation. Each day a violation of
9 this part or part II of chapter 408 occurs constitutes a
10 separate violation and is subject to a separate fine, but in
11 no event may any fine aggregate more than $5,000. A fine may
12 be levied pursuant to this section in lieu of and
13 notwithstanding the provisions of s. 400.23. Fines paid shall
14 be deposited in the Resident Protection Trust Fund and
15 expended as provided in s. 400.063.
16 (3) The agency shall revoke or deny a nursing home
17 license if the licensee or controlling interest operates a
18 facility in this state that:
19 (a) Has had two moratoria issued pursuant to this part
20 or part II of chapter 408 which are imposed by final order for
21 substandard quality of care, as defined by 42 C.F.R. part 483,
22 within any 30-month period;
23 (b) Is conditionally licensed for 180 or more
24 continuous days;
25 (c) Is cited for two class I deficiencies arising from
26 unrelated circumstances during the same survey or
27 investigation; or
28 (d) Is cited for two class I deficiencies arising from
29 separate surveys or investigations within a 30-month period.
30
31
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1 The licensee may present factors in mitigation of revocation,
2 and the agency may make a determination not to revoke a
3 license based upon a showing that revocation is inappropriate
4 under the circumstances.
5 (4) The agency may issue an order immediately
6 suspending or revoking a license when it determines that any
7 condition in the facility presents a danger to the health,
8 safety, or welfare of the residents in the facility.
9 (5)(a) The agency may impose an immediate moratorium
10 on admissions to any facility when the agency determines that
11 any condition in the facility presents a threat to the health,
12 safety, or welfare of the residents in the facility.
13 (4)(b) If Where the agency has placed a moratorium
14 pursuant to this part or part II of chapter 408 on admissions
15 on any facility two times within a 7-year period, the agency
16 may suspend the nursing home license of the nursing home and
17 the facility's management company, if any. During the
18 suspension, the agency shall take the facility into
19 receivership and shall operate the facility.
20 (5)(6) An action taken by the agency to deny, suspend,
21 or revoke a facility's license under this part or part II of
22 chapter 408 shall be heard by the Division of Administrative
23 Hearings of the Department of Management Services within 60
24 days after the assignment of an administrative law judge,
25 unless the time limitation is waived by both parties. The
26 administrative law judge must render a decision within 30 days
27 after receipt of a proposed recommended order.
28 (6)(7) The agency is authorized to require a facility
29 to increase staffing beyond the minimum required by law, if
30 the agency has taken administrative action against the
31 facility for care-related deficiencies directly attributable
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1 to insufficient staff. Under such circumstances, the facility
2 may request an expedited interim rate increase. The agency
3 shall process the request within 10 days after receipt of all
4 required documentation from the facility. A facility that
5 fails to maintain the required increased staffing is subject
6 to a fine of $500 per day for each day the staffing is below
7 the level required by the agency.
8 (8) An administrative proceeding challenging an action
9 taken by the agency pursuant to this section shall be reviewed
10 on the basis of the facts and conditions that resulted in such
11 agency action.
12 (7)(9) Notwithstanding any other provision of law to
13 the contrary, agency action in an administrative proceeding
14 under this section may be overcome by the licensee upon a
15 showing by a preponderance of the evidence to the contrary.
16 (8)(10) In addition to any other sanction imposed
17 under this part or part II of chapter 408, in any final order
18 that imposes sanctions, the agency may assess costs related to
19 the investigation and prosecution of the case. Payment of
20 agency costs shall be deposited into the Health Care Trust
21 Fund.
22 Section 68. Section 400.125, Florida Statutes, is
23 repealed.
24 Section 69. Subsection (14) of section 400.141,
25 Florida Statutes, is amended to read:
26 400.141 Administration and management of nursing home
27 facilities.--Every licensed facility shall comply with all
28 applicable standards and rules of the agency and shall:
29 (14) Submit to the agency the information specified in
30 s. 400.071(1)(a)(2)(e) for a management company within 30 days
31 after the effective date of the management agreement.
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1
2 Facilities that have been awarded a Gold Seal under the
3 program established in s. 400.235 may develop a plan to
4 provide certified nursing assistant training as prescribed by
5 federal regulations and state rules and may apply to the
6 agency for approval of their program.
7 Section 70. Section 400.179, Florida Statutes, is
8 amended to read:
9 400.179 Sale or transfer of ownership of a nursing
10 facility; Liability for Medicaid underpayments and
11 overpayments.--
12 (1) It is the intent of the Legislature to protect the
13 rights of nursing home residents and the security of public
14 funds when a nursing facility is sold or the ownership is
15 transferred.
16 (2) Whenever a nursing facility is sold or the
17 ownership is transferred, including leasing, the transferee
18 shall make application to the agency for a new license at
19 least 90 days prior to the date of transfer of ownership.
20 (3) The transferor shall notify the agency in writing
21 at least 90 days prior to the date of transfer of ownership.
22 The transferor shall be responsible and liable for the lawful
23 operation of the nursing facility and the welfare of the
24 residents domiciled in the facility until the date the
25 transferee is licensed by the agency. The transferor shall be
26 liable for any and all penalties imposed against the facility
27 for violations occurring prior to the date of transfer of
28 ownership.
29 (4) The transferor shall, prior to transfer of
30 ownership, repay or make arrangements to repay to the agency
31 or the Department of Children and Family Services any amounts
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1 owed to the agency or the department. Should the transferor
2 fail to repay or make arrangements to repay the amounts owed
3 to the agency or the department prior to the transfer of
4 ownership, the issuance of a license to the transferee shall
5 be delayed until repayment or until arrangements for repayment
6 are made.
7 (2)(5) Because any transfer of a nursing facility may
8 expose the fact that Medicaid may have underpaid or overpaid
9 the transferor, and because in most instances, any such
10 underpayment or overpayment can only be determined following a
11 formal field audit, the liabilities for any such underpayments
12 or overpayments shall be as follows:
13 (a) The Medicaid program shall be liable to the
14 transferor for any underpayments owed during the transferor's
15 period of operation of the facility.
16 (b) Without regard to whether the transferor had
17 leased or owned the nursing facility, the transferor shall
18 remain liable to the Medicaid program for all Medicaid
19 overpayments received during the transferor's period of
20 operation of the facility, regardless of when determined.
21 (c) Where the facility transfer takes any form of a
22 sale of assets, in addition to the transferor's continuing
23 liability for any such overpayments, if the transferor fails
24 to meet these obligations, the transferee shall be liable for
25 all liabilities that can be readily identifiable 90 days in
26 advance of the transfer. Such liability shall continue in
27 succession until the debt is ultimately paid or otherwise
28 resolved. It shall be the burden of the transferee to
29 determine the amount of all such readily identifiable
30 overpayments from the Agency for Health Care Administration,
31 and the agency shall cooperate in every way with the
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1 identification of such amounts. Readily identifiable
2 overpayments shall include overpayments that will result from,
3 but not be limited to:
4 1. Medicaid rate changes or adjustments;
5 2. Any depreciation recapture;
6 3. Any recapture of fair rental value system indexing;
7 or
8 4. Audits completed by the agency.
9
10 The transferor shall remain liable for any such Medicaid
11 overpayments that were not readily identifiable 90 days in
12 advance of the nursing facility transfer.
13 (d) Where the transfer involves a facility that has
14 been leased by the transferor:
15 1. The transferee shall, as a condition to being
16 issued a license by the agency, acquire, maintain, and provide
17 proof to the agency of a bond with a term of 30 months,
18 renewable annually, in an amount not less than the total of 3
19 months' Medicaid payments to the facility computed on the
20 basis of the preceding 12-month average Medicaid payments to
21 the facility.
22 2. A leasehold licensee may meet the requirements of
23 subparagraph 1. by payment of a nonrefundable fee, paid at
24 initial licensure, paid at the time of any subsequent change
25 of ownership, and paid annually thereafter at the time of any
26 subsequent annual license renewal, in the amount of 1 percent
27 of the total of 3 months' Medicaid payments to the facility
28 computed on the basis of the preceding 12-month average
29 Medicaid payments to the facility. If a preceding 12-month
30 average is not available, projected Medicaid payments may be
31 used. The fee shall be deposited into the Health Care Trust
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1 Fund and shall be accounted for separately as a Medicaid
2 nursing home overpayment account. These fees shall be used at
3 the sole discretion of the agency to repay nursing home
4 Medicaid overpayments. Payment of this fee shall not release
5 the licensee from any liability for any Medicaid overpayments,
6 nor shall payment bar the agency from seeking to recoup
7 overpayments from the licensee and any other liable party. As
8 a condition of exercising this lease bond alternative,
9 licensees paying this fee must maintain an existing lease bond
10 through the end of the 30-month term period of that bond. The
11 agency is herein granted specific authority to promulgate all
12 rules pertaining to the administration and management of this
13 account, including withdrawals from the account, subject to
14 federal review and approval. This provision shall take effect
15 upon becoming law and shall apply to any leasehold license
16 application. The financial viability of the Medicaid nursing
17 home overpayment account shall be determined by the agency
18 through annual review of the account balance and the amount of
19 total outstanding, unpaid Medicaid overpayments owing from
20 leasehold licensees to the agency as determined by final
21 agency audits.
22 3. The leasehold licensee may meet the bond
23 requirement through other arrangements acceptable to the
24 agency. The agency is herein granted specific authority to
25 promulgate rules pertaining to lease bond arrangements.
26 4. All existing nursing facility licensees, operating
27 the facility as a leasehold, shall acquire, maintain, and
28 provide proof to the agency of the 30-month bond required in
29 subparagraph 1., above, on and after July 1, 1993, for each
30 license renewal.
31
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1 5. It shall be the responsibility of all nursing
2 facility operators, operating the facility as a leasehold, to
3 renew the 30-month bond and to provide proof of such renewal
4 to the agency annually at the time of application for license
5 renewal.
6 6. Any failure of the nursing facility operator to
7 acquire, maintain, renew annually, or provide proof to the
8 agency shall be grounds for the agency to deny, cancel,
9 revoke, and or suspend the facility license to operate such
10 facility and to take any further action, including, but not
11 limited to, enjoining the facility, asserting a moratorium
12 pursuant to part II of chapter 408, or applying for a
13 receiver, deemed necessary to ensure compliance with this
14 section and to safeguard and protect the health, safety, and
15 welfare of the facility's residents. A lease agreement
16 required as a condition of bond financing or refinancing under
17 s. 154.213 by a health facilities authority or required under
18 s. 159.30 by a county or municipality is not a leasehold for
19 purposes of this paragraph and is not subject to the bond
20 requirement of this paragraph.
21 Section 71. Subsections (1) and (4) of section 400.18,
22 Florida Statutes, are amended to read:
23 400.18 Closing of nursing facility.--
24 (1) In addition to the requirements of part II of
25 chapter 408, Whenever a licensee voluntarily discontinues
26 operation, and during the period when it is preparing for such
27 discontinuance, it shall inform the agency not less than 90
28 days prior to the discontinuance of operation. the licensee
29 also shall inform each the resident or the next of kin, legal
30 representative, or agency acting on behalf of the resident of
31 the fact, and the proposed time, of such discontinuance of
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1 operation and give at least 90 days' notice so that suitable
2 arrangements may be made for the transfer and care of the
3 resident. In the event any resident has no such person to
4 represent him or her, the licensee shall be responsible for
5 securing a suitable transfer of the resident before the
6 discontinuance of operation. The agency shall be responsible
7 for arranging for the transfer of those residents requiring
8 transfer who are receiving assistance under the Medicaid
9 program.
10 (4) Immediately upon discontinuance of operation of a
11 facility, the licensee shall surrender the license therefor to
12 the agency, and the license shall be canceled.
13 Section 72. Subsections (1), (2), and (3) of section
14 400.19, Florida Statutes, are amended to read:
15 400.19 Right of entry and inspection.--
16 (1) In accordance with part II of chapter 408, the
17 agency and any duly designated officer or employee thereof or
18 a member of the State Long-Term Care Ombudsman Council or the
19 local long-term care ombudsman council shall have the right to
20 enter upon and into the premises of any facility licensed
21 pursuant to this part, or any distinct nursing home unit of a
22 hospital licensed under chapter 395 or any freestanding
23 facility licensed under chapter 395 that provides extended
24 care or other long-term care services, at any reasonable time
25 in order to determine the state of compliance with the
26 provisions of this part, part II of chapter 408, and
27 applicable rules in force pursuant thereto. The right of entry
28 and inspection shall also extend to any premises which the
29 agency has reason to believe is being operated or maintained
30 as a facility without a license, but no such entry or
31 inspection of any premises shall be made without the
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1 permission of the owner or person in charge thereof, unless a
2 warrant is first obtained from the circuit court authorizing
3 same. Any application for a facility license or renewal
4 thereof, made pursuant to this part, shall constitute
5 permission for and complete acquiescence in any entry or
6 inspection of the premises for which the license is sought, in
7 order to facilitate verification of the information submitted
8 on or in connection with the application; to discover,
9 investigate, and determine the existence of abuse or neglect;
10 or to elicit, receive, respond to, and resolve complaints. The
11 agency shall, within 60 days after receipt of a complaint made
12 by a resident or resident's representative, complete its
13 investigation and provide to the complainant its findings and
14 resolution.
15 (2) The agency shall coordinate nursing home facility
16 licensing activities and responsibilities of any duly
17 designated officer or employee involved in nursing home
18 facility inspection to assure necessary, equitable, and
19 consistent supervision of inspection personnel without
20 unnecessary duplication of inspections, consultation services,
21 or complaint investigations. To facilitate such coordination,
22 all rules promulgated by the agency pursuant to this part
23 shall be distributed to nursing homes licensed under s.
24 400.062 30 days prior to implementation. This requirement does
25 not apply to emergency rules.
26 (3) The agency shall every 15 months conduct at least
27 one unannounced inspection to determine compliance by the
28 licensee with statutes, and with rules promulgated under the
29 provisions of those statutes, governing minimum standards of
30 construction, quality and adequacy of care, and rights of
31 residents. The survey shall be conducted every 6 months for
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1 the next 2-year period if the facility has been cited for a
2 class I deficiency, has been cited for two or more class II
3 deficiencies arising from separate surveys or investigations
4 within a 60-day period, or has had three or more substantiated
5 complaints within a 6-month period, each resulting in at least
6 one class I or class II deficiency. In addition to any other
7 fees or fines in this part, the agency shall assess a fine for
8 each facility that is subject to the 6-month survey cycle. The
9 fine for the 2-year period shall be $6,000, one-half to be
10 paid at the completion of each survey. The agency may adjust
11 this fine by the change in the Consumer Price Index, based on
12 the 12 months immediately preceding the increase, to cover the
13 cost of the additional surveys. The agency shall verify
14 through subsequent inspection that any deficiency identified
15 during the annual inspection is corrected. However, the agency
16 may verify the correction of a class III or class IV
17 deficiency unrelated to resident rights or resident care
18 without reinspecting the facility if adequate written
19 documentation has been received from the facility, which
20 provides assurance that the deficiency has been corrected. The
21 giving or causing to be given of advance notice of such
22 unannounced inspections by an employee of the agency to any
23 unauthorized person shall constitute cause for suspension of
24 not fewer than 5 working days according to the provisions of
25 chapter 110.
26 Section 73. Subsections (1) and (3) of section
27 400.191, Florida Statutes, are amended to read:
28 400.191 Availability, distribution, and posting of
29 reports and records.--
30 (1) The agency shall provide information to the public
31 about all of the licensed nursing home facilities operating in
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1 the state. The agency shall, within 60 days after a licensure
2 an annual inspection visit or within 30 days after any interim
3 visit to a facility, send copies of the inspection reports to
4 the local long-term care ombudsman council, the agency's local
5 office, and a public library or the county seat for the county
6 in which the facility is located. The agency may provide
7 electronic access to inspection reports as a substitute for
8 sending copies.
9 (3) Each nursing home facility licensee shall maintain
10 as public information, available upon request, records of all
11 cost and inspection reports pertaining to that facility that
12 have been filed with, or issued by, any governmental agency.
13 Copies of the reports shall be retained in the records for not
14 less than 5 years following the date the reports are filed or
15 issued.
16 (a) The agency shall publish in the Nursing Home Guide
17 a "Nursing Home Guide Watch List" to assist consumers in
18 evaluating the quality of nursing home care in Florida. The
19 watch list must identify each facility that met the criteria
20 for a conditional licensure status and each facility that is
21 operating under bankruptcy protection. The watch list must
22 include, but is not limited to, the facility's name, address,
23 and ownership; the county in which the facility operates; the
24 license expiration date; the number of licensed beds; a
25 description of the deficiency causing the facility to be
26 placed on the list; any corrective action taken; and the
27 cumulative number of days and percentage of days the facility
28 had a conditional license in the past 30 months. The watch
29 list must include a brief description regarding how to choose
30 a nursing home, the categories of licensure, the agency's
31 inspection process, an explanation of terms used in the watch
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1 list, and the addresses and phone numbers of the agency's
2 health quality assurance field offices.
3 (b) Upon publication of each Nursing Home Guide, the
4 agency must post a copy on its website by the 15th calendar
5 day of the second month following the end of the calendar
6 quarter. Each nursing home licensee must retrieve the most
7 recent version of the Nursing Home Guide from the agency's
8 website.
9 Section 74. Subsections (1), (2), (7), and (8) of
10 section 400.23, Florida Statutes, are amended to read:
11 400.23 Rules; evaluation and deficiencies; licensure
12 status.--
13 (1) It is the intent of the Legislature that rules
14 published and enforced pursuant to this part and part II of
15 chapter 408 shall include criteria by which a reasonable and
16 consistent quality of resident care may be ensured and the
17 results of such resident care can be demonstrated and by which
18 safe and sanitary nursing homes can be provided. It is
19 further intended that reasonable efforts be made to
20 accommodate the needs and preferences of residents to enhance
21 the quality of life in a nursing home. In addition, efforts
22 shall be made to minimize the paperwork associated with the
23 reporting and documentation requirements of these rules.
24 (2) Pursuant to the intention of the Legislature, the
25 agency, in consultation with the Department of Health and the
26 Department of Elderly Affairs, shall adopt and enforce rules
27 to implement this part and part II of chapter 408, which shall
28 include reasonable and fair criteria in relation to:
29 (a) The location of the facility and housing
30 conditions that will ensure the health, safety, and comfort of
31 residents, including an adequate call system. In making such
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1 rules, the agency shall be guided by criteria recommended by
2 nationally recognized reputable professional groups and
3 associations with knowledge of such subject matters. The
4 agency shall update or revise such criteria as the need
5 arises. The agency may require alterations to a building if it
6 determines that an existing condition constitutes a distinct
7 hazard to life, health, or safety. In performing any
8 inspections of facilities authorized by this part or part II
9 of chapter 408, the agency may enforce the special-occupancy
10 provisions of the Florida Building Code and the Florida Fire
11 Prevention Code which apply to nursing homes. Residents or
12 their representatives shall be able to request a change in the
13 placement of the bed in their room, provided that at admission
14 they are presented with a room that meets requirements of the
15 Florida Building Code. The location of a bed may be changed if
16 the requested placement does not infringe on the resident's
17 roommate or interfere with the resident's care or safety as
18 determined by the care planning team in accordance with
19 facility policies and procedures. In addition, the bed
20 placement may not be used as a restraint. Each facility shall
21 maintain a log of resident rooms with beds that are not in
22 strict compliance with the Florida Building Code in order for
23 such log to be used by surveyors and nurse monitors during
24 inspections and visits. A resident or resident representative
25 who requests that a bed be moved shall sign a statement
26 indicating that he or she understands the room will not be in
27 compliance with the Florida Building Code, but they would
28 prefer to exercise their right to self-determination. The
29 statement must be retained as part of the resident's care
30 plan. Any facility that offers this option must submit a
31 letter signed by the nursing home administrator of record to
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1 the agency notifying it of this practice with a copy of the
2 policies and procedures of the facility. The agency is
3 directed to provide assistance to the Florida Building
4 Commission in updating the construction standards of the code
5 relative to nursing homes.
6 (b) The number and qualifications of all personnel,
7 including management, medical, nursing, and other professional
8 personnel, and nursing assistants, orderlies, and support
9 personnel, having responsibility for any part of the care
10 given residents.
11 (c) All sanitary conditions within the facility and
12 its surroundings, including water supply, sewage disposal,
13 food handling, and general hygiene which will ensure the
14 health and comfort of residents.
15 (d) The equipment essential to the health and welfare
16 of the residents.
17 (e) A uniform accounting system.
18 (f) The care, treatment, and maintenance of residents
19 and measurement of the quality and adequacy thereof, based on
20 rules developed under this chapter and the Omnibus Budget
21 Reconciliation Act of 1987 (Pub. L. No. 100-203) (December 22,
22 1987), Title IV (Medicare, Medicaid, and Other Health-Related
23 Programs), Subtitle C (Nursing Home Reform), as amended.
24 (g) The preparation and annual update of a
25 comprehensive emergency management plan. The agency shall
26 adopt rules establishing minimum criteria for the plan after
27 consultation with the Department of Community Affairs. At a
28 minimum, the rules must provide for plan components that
29 address emergency evacuation transportation; adequate
30 sheltering arrangements; postdisaster activities, including
31 emergency power, food, and water; postdisaster transportation;
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1 supplies; staffing; emergency equipment; individual
2 identification of residents and transfer of records; and
3 responding to family inquiries. The comprehensive emergency
4 management plan is subject to review and approval by the local
5 emergency management agency. During its review, the local
6 emergency management agency shall ensure that the following
7 agencies, at a minimum, are given the opportunity to review
8 the plan: the Department of Elderly Affairs, the Department
9 of Health, the Agency for Health Care Administration, and the
10 Department of Community Affairs. Also, appropriate volunteer
11 organizations must be given the opportunity to review the
12 plan. The local emergency management agency shall complete
13 its review within 60 days and either approve the plan or
14 advise the facility of necessary revisions.
15 (h) The availability, distribution, and posting of
16 reports and records pursuant to s. 400.191 and the Gold Seal
17 Program pursuant to s. 400.235.
18 (7) The agency shall, at least every 15 months,
19 evaluate all nursing home facilities and make a determination
20 as to the degree of compliance by each licensee with the
21 established rules adopted under this part as a basis for
22 assigning a licensure status to that facility. The agency
23 shall base its evaluation on the most recent inspection
24 report, taking into consideration findings from other official
25 reports, surveys, interviews, investigations, and inspections.
26 In addition to license categories authorized under part II of
27 chapter 408, the agency shall assign a licensure status of
28 standard or conditional to each nursing home.
29 (a) A standard licensure status means that a facility
30 has no class I or class II deficiencies and has corrected all
31
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1 class III deficiencies within the time established by the
2 agency.
3 (b) A conditional licensure status means that a
4 facility, due to the presence of one or more class I or class
5 II deficiencies, or class III deficiencies not corrected
6 within the time established by the agency, is not in
7 substantial compliance at the time of the survey with criteria
8 established under this part or with rules adopted by the
9 agency. If the facility has no class I, class II, or class
10 III deficiencies at the time of the followup survey, a
11 standard licensure status may be assigned.
12 (c) In evaluating the overall quality of care and
13 services and determining whether the facility will receive a
14 conditional or standard license, the agency shall consider the
15 needs and limitations of residents in the facility and the
16 results of interviews and surveys of a representative sampling
17 of residents, families of residents, ombudsman council members
18 in the planning and service area in which the facility is
19 located, guardians of residents, and staff of the nursing home
20 facility.
21 (d) The current licensure status of each facility must
22 be indicated in bold print on the face of the license. A list
23 of the deficiencies of the facility shall be posted in a
24 prominent place that is in clear and unobstructed public view
25 at or near the place where residents are being admitted to
26 that facility. Licensees receiving a conditional licensure
27 status for a facility shall prepare, within 10 working days
28 after receiving notice of deficiencies, a plan for correction
29 of all deficiencies and shall submit the plan to the agency
30 for approval.
31
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1 (e) Each licensee shall post its license in a
2 prominent place that is in clear and unobstructed public view
3 at or near the place where residents are being admitted to the
4 facility.
5 (e)(f) The agency shall adopt rules that:
6 1. Establish uniform procedures for the evaluation of
7 facilities.
8 2. Provide criteria in the areas referenced in
9 paragraph (c).
10 3. Address other areas necessary for carrying out the
11 intent of this section.
12 (8) The agency shall adopt rules pursuant to this part
13 and part II of chapter 408 to provide that, when the criteria
14 established under subsection (2) are not met, such
15 deficiencies shall be classified according to the nature and
16 the scope of the deficiency. The scope shall be cited as
17 isolated, patterned, or widespread. An isolated deficiency is
18 a deficiency affecting one or a very limited number of
19 residents, or involving one or a very limited number of staff,
20 or a situation that occurred only occasionally or in a very
21 limited number of locations. A patterned deficiency is a
22 deficiency where more than a very limited number of residents
23 are affected, or more than a very limited number of staff are
24 involved, or the situation has occurred in several locations,
25 or the same resident or residents have been affected by
26 repeated occurrences of the same deficient practice but the
27 effect of the deficient practice is not found to be pervasive
28 throughout the facility. A widespread deficiency is a
29 deficiency in which the problems causing the deficiency are
30 pervasive in the facility or represent systemic failure that
31 has affected or has the potential to affect a large portion of
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1 the facility's residents. The agency shall indicate the
2 classification on the face of the notice of deficiencies as
3 follows:
4 (a) A class I deficiency is a deficiency that the
5 agency determines presents a situation in which immediate
6 corrective action is necessary because the facility's
7 noncompliance has caused, or is likely to cause, serious
8 injury, harm, impairment, or death to a resident receiving
9 care in a facility. The condition or practice constituting a
10 class I violation shall be abated or eliminated immediately,
11 unless a fixed period of time, as determined by the agency, is
12 required for correction. A class I deficiency is subject to a
13 civil penalty of $10,000 for an isolated deficiency, $12,500
14 for a patterned deficiency, and $15,000 for a widespread
15 deficiency. The fine amount shall be doubled for each
16 deficiency if the facility was previously cited for one or
17 more class I or class II deficiencies during the last
18 licensure annual inspection or any inspection or complaint
19 investigation since the last licensure annual inspection. A
20 fine must be levied notwithstanding the correction of the
21 deficiency.
22 (b) A class II deficiency is a deficiency that the
23 agency determines has compromised the resident's ability to
24 maintain or reach his or her highest practicable physical,
25 mental, and psychosocial well-being, as defined by an accurate
26 and comprehensive resident assessment, plan of care, and
27 provision of services. A class II deficiency is subject to a
28 civil penalty of $2,500 for an isolated deficiency, $5,000 for
29 a patterned deficiency, and $7,500 for a widespread
30 deficiency. The fine amount shall be doubled for each
31 deficiency if the facility was previously cited for one or
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1 more class I or class II deficiencies during the last
2 licensure annual inspection or any inspection or complaint
3 investigation since the last licensure annual inspection. A
4 fine shall be levied notwithstanding the correction of the
5 deficiency.
6 (c) A class III deficiency is a deficiency that the
7 agency determines will result in no more than minimal
8 physical, mental, or psychosocial discomfort to the resident
9 or has the potential to compromise the resident's ability to
10 maintain or reach his or her highest practical physical,
11 mental, or psychosocial well-being, as defined by an accurate
12 and comprehensive resident assessment, plan of care, and
13 provision of services. A class III deficiency is subject to a
14 civil penalty of $1,000 for an isolated deficiency, $2,000 for
15 a patterned deficiency, and $3,000 for a widespread
16 deficiency. The fine amount shall be doubled for each
17 deficiency if the facility was previously cited for one or
18 more class I or class II deficiencies during the last
19 licensure annual inspection or any inspection or complaint
20 investigation since the last licensure annual inspection. A
21 citation for a class III deficiency must specify the time
22 within which the deficiency is required to be corrected. If a
23 class III deficiency is corrected within the time specified, a
24 no civil penalty may not shall be imposed.
25 (d) A class IV deficiency is a deficiency that the
26 agency determines has the potential for causing no more than a
27 minor negative impact on the resident. If the class IV
28 deficiency is isolated, no plan of correction is required.
29 Section 75. Section 400.241, Florida Statutes, is
30 amended to read:
31 400.241 Prohibited acts; penalties for violations.--
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1 (1) It is unlawful for any person or public body to
2 establish, conduct, manage, or operate a home as defined in
3 this part without obtaining a valid current license.
4 (2) It is unlawful for any person or public body to
5 offer or advertise to the public, in any way by any medium
6 whatever, nursing home care or service or custodial services
7 without obtaining a valid current license. It is unlawful for
8 any holder of a license issued pursuant to the provisions of
9 this part to advertise or hold out to the public that it holds
10 a license for a facility other than that for which it actually
11 holds a license.
12 (1)(3) It is unlawful for any person, long-term care
13 facility, or other entity to willfully interfere with the
14 unannounced inspections mandated by s. 400.19(3) or part II of
15 chapter 408. Alerting or advising a facility of the actual or
16 approximate date of such inspection shall be a per se
17 violation of this subsection.
18 (2)(4) A violation of any provision of this part or of
19 any minimum standard, rule, or regulation adopted pursuant
20 thereto constitutes a misdemeanor of the second degree,
21 punishable as provided in s. 775.082 or s. 775.083. Each day
22 of a continuing violation is shall be considered a separate
23 offense.
24 Section 76. Subsection (1) and paragraphs (a) and (c)
25 of subsection (4) of section 400.464, Florida Statutes, are
26 amended to read:
27 400.464 Home health agencies to be licensed;
28 expiration of license; exemptions; unlawful acts; penalties.--
29 (1) The requirements of part II of chapter 408 apply
30 to the provision of services that require licensure pursuant
31 to this part and part II of chapter 408 and entities licensed
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1 or registered by or applying for such licensure or
2 registration from the Agency for Health Care Administration
3 pursuant to this part. A license issued by the agency is
4 required in order to operate a home health agency in this
5 state. Any home health agency must be licensed by the agency
6 to operate in this state. A license issued to a home health
7 agency, unless sooner suspended or revoked, expires 2 years
8 after its date of issuance.
9 (4)(a) An organization may not provide, offer, or
10 advertise home health services to the public unless the
11 organization has a valid license or is specifically exempted
12 under this part. An organization that offers or advertises to
13 the public any service for which licensure or registration is
14 required under this part must include in the advertisement the
15 license number or registration number issued to the
16 organization by the agency. The agency shall assess a fine of
17 not less than $100 to any licensee or registrant who fails to
18 include the license or registration number when submitting the
19 advertisement for publication, broadcast, or printing. The
20 fine for a second or subsequent offense is $500. The holder of
21 a license issued under this part may not advertise or indicate
22 to the public that it holds a home health agency or nurse
23 registry license other than the one it has been issued.
24 (c) A person who violates paragraph (a) is subject to
25 an injunctive proceeding under s. 408.816 s. 400.515. A
26 violation of paragraph (a) or s. 408.812 is a deceptive and
27 unfair trade practice and constitutes a violation of the
28 Florida Deceptive and Unfair Trade Practices Act under part II
29 of chapter 501.
30 Section 77. Section 400.471, Florida Statutes, is
31 amended to read:
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1 400.471 Application for license; fee; provisional
2 license; temporary permit.--
3 (1) Each applicant for licensure must comply with all
4 provisions of this part and part II of chapter 408.
5 Application for an initial license or for renewal of an
6 existing license must be made under oath to the agency on
7 forms furnished by it and must be accompanied by the
8 appropriate license fee as provided in subsection (10). The
9 agency must take final action on an initial licensure
10 application within 60 days after receipt of all required
11 documentation.
12 (2) In addition to the requirements of part II of
13 chapter 408, the initial applicant must file with the
14 application satisfactory proof that the home health agency is
15 in compliance with this part and applicable rules, including:
16 (a) A listing of services to be provided, either
17 directly by the applicant or through contractual arrangements
18 with existing providers.
19 (b) The number and discipline of professional staff to
20 be employed.
21 (c) Proof of financial ability to operate.
22 (c)(d) Completion of questions concerning volume data
23 on the renewal application as determined by rule.
24 (3) An applicant for initial licensure must
25 demonstrate financial ability to operate by submitting a
26 balance sheet and income and expense statement for the first 2
27 years of operation which provide evidence of having sufficient
28 assets, credit, and projected revenues to cover liabilities
29 and expenses. The applicant shall have demonstrated financial
30 ability to operate if the applicant's assets, credit, and
31 projected revenues meet or exceed projected liabilities and
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1 expenses. All documents required under this subsection must be
2 prepared in accordance with generally accepted accounting
3 principles and must be compiled by a certified public
4 accountant.
5 (4) Each applicant for licensure must comply with the
6 following requirements:
7 (a) Upon receipt of a completed, signed, and dated
8 application, the agency shall require background screening of
9 the applicant, in accordance with the level 2 standards for
10 screening set forth in chapter 435. As used in this
11 subsection, the term "applicant" means the administrator, or a
12 similarly titled person who is responsible for the day-to-day
13 operation of the licensed home health agency, and the
14 financial officer, or similarly titled individual who is
15 responsible for the financial operation of the licensed home
16 health agency.
17 (b) The agency may require background screening for a
18 member of the board of directors of the licensee or an officer
19 or an individual owning 5 percent or more of the licensee if
20 the agency reasonably suspects that such individual has been
21 convicted of an offense prohibited under the level 2 standards
22 for screening set forth in chapter 435.
23 (c) Proof of compliance with the level 2 background
24 screening requirements of chapter 435 which has been submitted
25 within the previous 5 years in compliance with any other
26 health care or assisted living licensure requirements of this
27 state is acceptable in fulfillment of paragraph (a). Proof of
28 compliance with background screening which has been submitted
29 within the previous 5 years to fulfill the requirements of the
30 Financial Services Commission and the Office of Insurance
31 Regulation pursuant to chapter 651 as part of an application
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1 for a certificate of authority to operate a continuing care
2 retirement community is acceptable in fulfillment of the
3 Department of Law Enforcement and Federal Bureau of
4 Investigation background check.
5 (d) A provisional license may be granted to an
6 applicant when each individual required by this section to
7 undergo background screening has met the standards for the
8 Department of Law Enforcement background check, but the agency
9 has not yet received background screening results from the
10 Federal Bureau of Investigation. A standard license may be
11 granted to the licensee upon the agency's receipt of a report
12 of the results of the Federal Bureau of Investigation
13 background screening for each individual required by this
14 section to undergo background screening which confirms that
15 all standards have been met, or upon the granting of a
16 disqualification exemption by the agency as set forth in
17 chapter 435. Any other person who is required to undergo level
18 2 background screening may serve in his or her capacity
19 pending the agency's receipt of the report from the Federal
20 Bureau of Investigation. However, the person may not continue
21 to serve if the report indicates any violation of background
22 screening standards and a disqualification exemption has not
23 been requested of and granted by the agency as set forth in
24 chapter 435.
25 (e) Each applicant must submit to the agency, with its
26 application, a description and explanation of any exclusions,
27 permanent suspensions, or terminations of the licensee or
28 potential licensee from the Medicare or Medicaid programs.
29 Proof of compliance with the requirements for disclosure of
30 ownership and control interest under the Medicaid or Medicare
31 programs may be accepted in lieu of this submission.
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1 (f) Each applicant must submit to the agency a
2 description and explanation of any conviction of an offense
3 prohibited under the level 2 standards of chapter 435 by a
4 member of the board of directors of the applicant, its
5 officers, or any individual owning 5 percent or more of the
6 applicant. This requirement does not apply to a director of a
7 not-for-profit corporation or organization if the director
8 serves solely in a voluntary capacity for the corporation or
9 organization, does not regularly take part in the day-to-day
10 operational decisions of the corporation or organization,
11 receives no remuneration for his or her services on the
12 corporation or organization's board of directors, and has no
13 financial interest and has no family members with a financial
14 interest in the corporation or organization, provided that the
15 director and the not-for-profit corporation or organization
16 include in the application a statement affirming that the
17 director's relationship to the corporation satisfies the
18 requirements of this paragraph.
19 (g) A license may not be granted to an applicant if
20 the applicant, administrator, or financial officer has been
21 found guilty of, regardless of adjudication, or has entered a
22 plea of nolo contendere or guilty to, any offense prohibited
23 under the level 2 standards for screening set forth in chapter
24 435, unless an exemption from disqualification has been
25 granted by the agency as set forth in chapter 435.
26 (h) The agency may deny or revoke licensure if the
27 applicant has been or is currently excluded, suspended,
28 terminated from, or has involuntarily withdrawn from
29 participation in any governmental or private health care or
30 health insurance program.
31
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1 (i) An application for license renewal must contain
2 the information required under paragraphs (e) and (f).
3 (5) The agency may deny or revoke licensure if the
4 applicant has falsely represented a material fact, or has
5 omitted any material fact, from the application required by
6 this section.
7 (3)(6) In addition to the requirements of s. 408.810,
8 the home health agency must also obtain and maintain the
9 following insurance coverage in an amount of not less than
10 $250,000 per claim, and the home health agency must submit
11 proof of coverage with an initial application for licensure
12 and with each application for license renewal:
13 (a) Malpractice insurance as defined in s.
14 624.605(1)(k).;
15 (b) Liability insurance as defined in s.
16 624.605(1)(b).
17 (7) Sixty days before the expiration date, an
18 application for renewal must be submitted to the agency under
19 oath on forms furnished by it, and a license must be renewed
20 if the applicant has met the requirements established under
21 this part and applicable rules. The home health agency must
22 file with the application satisfactory proof that it is in
23 compliance with this part and applicable rules. If there is
24 evidence of financial instability, the home health agency must
25 submit satisfactory proof of its financial ability to comply
26 with the requirements of this part. The agency shall impose an
27 administrative fine of $50 per day for each day the home
28 health agency fails to file an application within the
29 timeframe specified in this subsection. Each day of continuing
30 violation is a separate violation; however, the aggregate of
31 such fines may not exceed $500.
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1 (8) When transferring the ownership of a home health
2 agency, the transferee must submit an application for a
3 license at least 60 days before the effective date of the
4 transfer. If the application is filed late, an administrative
5 fine shall be imposed in the amount of $50 per day. Each day
6 of continuing violation is a separate violation; however, the
7 aggregate of such fines may not exceed $500. If the home
8 health agency is being leased, a copy of the lease agreement
9 must be filed with the application.
10 (4)(9) The agency shall accept, in lieu of its own
11 periodic licensure survey, submission of the survey of an
12 accrediting organization that is recognized by the agency if
13 the accreditation of the licensed home health agency is not
14 provisional and if the licensed home health agency authorizes
15 release of, and the agency receives the report of, the
16 accrediting organization.
17 (5)(10) In accordance with s. 408.805, an applicant or
18 licensee shall pay a fee for each license application
19 submitted under this part, part II of chapter 408, and
20 applicable rules. The amount of the fee shall be established
21 by rule and shall be set at The license fee and renewal fee
22 required of a home health agency are nonrefundable. The agency
23 shall set the license fees in an amount that is sufficient to
24 cover the agency's its costs in carrying out its
25 responsibilities under this part, but not to exceed $2,000 per
26 biennium. However, state, county, or municipal governments
27 applying for licenses under this part are exempt from the
28 payment of license fees. All fees collected under this part
29 must be deposited in the Health Care Trust Fund for the
30 administration of this part.
31
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1 (11) The license must be displayed in a conspicuous
2 place in the administrative office of the home health agency
3 and is valid only while in the possession of the person to
4 which it is issued. The license may not be sold, assigned, or
5 otherwise transferred, voluntarily or involuntarily, and is
6 valid only for the home health agency and location for which
7 originally issued.
8 (12) A home health agency against whom a revocation or
9 suspension proceeding is pending at the time of license
10 renewal may be issued a provisional license effective until
11 final disposition by the agency of such proceedings. If
12 judicial relief is sought from the final disposition, the
13 court that has jurisdiction may issue a temporary permit for
14 the duration of the judicial proceeding.
15 (6)(13) The agency may not issue a license designated
16 as certified to a home health agency that fails to satisfy the
17 requirements of a Medicare certification survey from the
18 agency.
19 (14) The agency may not issue a license to a home
20 health agency that has any unpaid fines assessed under this
21 part.
22 Section 78. Section 400.474, Florida Statutes, is
23 amended to read:
24 400.474 Administrative Denial, suspension, revocation
25 of license; injunction; grounds; penalties.--
26 (1) The agency may deny, revoke, and or suspend a
27 license and, or impose an administrative fine in the manner
28 provided in chapter 120, or initiate injunctive proceedings
29 under s. 400.515.
30
31
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1 (2) Any of the following actions by a home health
2 agency or its employee is grounds for disciplinary action by
3 the agency:
4 (a) Violation of this part, part II of chapter 408, or
5 of applicable rules.
6 (b) An intentional, reckless, or negligent act that
7 materially affects the health or safety of a patient.
8 (c) Knowingly providing home health services in an
9 unlicensed assisted living facility or unlicensed adult
10 family-care home, unless the home health agency or employee
11 reports the unlicensed facility or home to the agency within
12 72 hours after providing the services.
13 (3) The agency may impose the following penalties for
14 operating without a license upon an applicant or owner who has
15 in the past operated, or who currently operates, a licensed
16 home health agency.
17 (a) If a home health agency that is found to be
18 operating without a license wishes to apply for a license, the
19 home health agency may submit an application only after the
20 agency has verified that the home health agency no longer
21 operates an unlicensed home health agency.
22 (a)(b) In addition to the requirements of s. 408.813,
23 any person, partnership, or corporation that violates s.
24 408.813 paragraph (a) and that previously operated a licensed
25 home health agency or concurrently operates both a licensed
26 home health agency and an unlicensed home health agency
27 commits a felony of the third degree punishable as provided in
28 s. 775.082, s. 775.083, or s. 775.084. If an owner has an
29 interest in more than one home health agency and fails to
30 license any one of those home health agencies, the agency must
31 issue a cease and desist order for the activities of the
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1 unlicensed home health agency and impose a moratorium on any
2 or all of the licensed related home health agencies until the
3 unlicensed home health agency is licensed.
4 (b)(c) If any home health agency is found to be
5 operating without a license meets the criteria in paragraph
6 (a) or paragraph (b) and that home health agency has received
7 any government reimbursement for services provided by an
8 unlicensed home health agency, the agency shall make a fraud
9 referral to the appropriate government reimbursement program.
10 (4) The agency may deny, revoke, or suspend the
11 license of a home health agency, or may impose on a home
12 health agency administrative fines not to exceed the aggregate
13 sum of $5,000 if:
14 (a) The agency is unable to obtain entry to the home
15 health agency to conduct a licensure survey, complaint
16 investigation, surveillance visit, or monitoring visit.
17 (b) An applicant or a licensed home health agency has
18 falsely represented a material fact in the application, or has
19 omitted from the application any material fact, including, but
20 not limited to, the fact that the controlling or ownership
21 interest is held by any officer, director, agent, manager,
22 employee, affiliated person, partner, or shareholder who is
23 not eligible to participate.
24 (c) An applicant, owner, or person who has a 5 percent
25 or greater interest in a licensed entity:
26 1. Has been previously found by any licensing,
27 certifying, or professional standards board or agency to have
28 violated the standards or conditions that relate to home
29 health-related licensure or certification, or to the quality
30 of home health-related services provided; or
31
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1 2. Has been or is currently excluded, suspended,
2 terminated from, or has involuntarily withdrawn from,
3 participation in the Medicaid program of this state or any
4 other state, the Medicare program, or any other governmental
5 health care or health insurance program.
6 Section 79. Subsection (1) and paragraphs (a) and (b)
7 of subsection (2) of section 400.484, Florida Statutes, are
8 amended to read:
9 400.484 Right of inspection; deficiencies; fines.--
10 (1) In addition to the requirements of s. 408.811, Any
11 duly authorized officer or employee of the agency may make
12 such inspections and investigations as are necessary in order
13 to determine the state of compliance with this part, part II
14 of chapter 408, and with applicable rules. The right of
15 inspection extends to any business that the agency has reason
16 to believe is being operated as a home health agency without a
17 license, but such inspection of any such business may not be
18 made without the permission of the owner or person in charge
19 unless a warrant is first obtained from a circuit court. Any
20 application for a license issued under this part or for
21 license renewal constitutes permission for an appropriate
22 inspection to verify the information submitted on or in
23 connection with the application.
24 (2) The agency shall impose fines for various classes
25 of deficiencies in accordance with the following schedule:
26 (a) A class I deficiency is any act, omission, or
27 practice that results in a patient's death, disablement, or
28 permanent injury, or places a patient at imminent risk of
29 death, disablement, or permanent injury. Upon finding a class
30 I deficiency, the agency may impose an administrative fine in
31 the amount of $5,000 for each occurrence and each day that the
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1 deficiency exists. In addition, the agency may immediately
2 revoke the license, or impose a moratorium on the admission of
3 new patients, until the factors causing the deficiency have
4 been corrected.
5 (b) A class II deficiency is any act, omission, or
6 practice that has a direct adverse effect on the health,
7 safety, or security of a patient. Upon finding a class II
8 deficiency, the agency may impose an administrative fine in
9 the amount of $1,000 for each occurrence and each day that the
10 deficiency exists. In addition, the agency may suspend the
11 license, or impose a moratorium on the admission of new
12 patients, until the deficiency has been corrected.
13 Section 80. Section 400.495, Florida Statutes, is
14 repealed.
15 Section 81. Section 400.497, Florida Statutes, is
16 amended to read:
17 400.497 Rules establishing minimum standards.--The
18 agency shall adopt, publish, and enforce rules to implement
19 part II of chapter 408 and this part, including, as
20 applicable, ss. 400.506 and 400.509, which must provide
21 reasonable and fair minimum standards relating to:
22 (1) The home health aide competency test and home
23 health aide training. The agency shall create the home health
24 aide competency test and establish the curriculum and
25 instructor qualifications for home health aide training.
26 Licensed home health agencies may provide this training and
27 shall furnish documentation of such training to other licensed
28 home health agencies upon request. Successful passage of the
29 competency test by home health aides may be substituted for
30 the training required under this section and any rule adopted
31 pursuant thereto.
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1 (2) Shared staffing. The agency shall allow shared
2 staffing if the home health agency is part of a retirement
3 community that provides multiple levels of care, is located on
4 one campus, is licensed under this chapter or chapter 429, and
5 otherwise meets the requirements of law and rule.
6 (3) The criteria for the frequency of onsite licensure
7 surveys.
8 (4) Licensure application and renewal.
9 (5) The requirements for onsite and electronic
10 accessibility of supervisory personnel of home health
11 agencies.
12 (6) Information to be included in patients' records.
13 (7) Geographic service areas.
14 (8) Preparation of a comprehensive emergency
15 management plan pursuant to s. 400.492.
16 (a) The Agency for Health Care Administration shall
17 adopt rules establishing minimum criteria for the plan and
18 plan updates, with the concurrence of the Department of Health
19 and in consultation with the Department of Community Affairs.
20 (b) The rules must address the requirements in s.
21 400.492. In addition, the rules shall provide for the
22 maintenance of patient-specific medication lists that can
23 accompany patients who are transported from their homes.
24 (c) The plan is subject to review and approval by the
25 county health department. During its review, the county health
26 department shall contact state and local health and medical
27 stakeholders when necessary. The county health department
28 shall complete its review to ensure that the plan is in
29 accordance with the criteria in the Agency for Health Care
30 Administration rules within 90 days after receipt of the plan
31 and shall approve the plan or advise the home health agency of
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1 necessary revisions. If the home health agency fails to submit
2 a plan or fails to submit the requested information or
3 revisions to the county health department within 30 days after
4 written notification from the county health department, the
5 county health department shall notify the Agency for Health
6 Care Administration. The agency shall notify the home health
7 agency that its failure constitutes a deficiency, subject to a
8 fine of $5,000 per occurrence. If the plan is not submitted,
9 information is not provided, or revisions are not made as
10 requested, the agency may impose the fine.
11 (d) For any home health agency that operates in more
12 than one county, the Department of Health shall review the
13 plan, after consulting with state and local health and medical
14 stakeholders when necessary. The department shall complete its
15 review within 90 days after receipt of the plan and shall
16 approve the plan or advise the home health agency of necessary
17 revisions. The department shall make every effort to avoid
18 imposing differing requirements on a home health agency that
19 operates in more than one county as a result of differing or
20 conflicting comprehensive plan requirements of the counties in
21 which the home health agency operates.
22 (e) The requirements in this subsection do not apply
23 to:
24 1. A facility that is certified under chapter 651 and
25 has a licensed home health agency used exclusively by
26 residents of the facility; or
27 2. A retirement community that consists of residential
28 units for independent living and either a licensed nursing
29 home or an assisted living facility, and has a licensed home
30 health agency used exclusively by the residents of the
31 retirement community, provided the comprehensive emergency
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1 management plan for the facility or retirement community
2 provides for continuous care of all residents with special
3 needs during an emergency.
4 Section 82. Section 400.506, Florida Statutes, is
5 amended to read:
6 400.506 Licensure of nurse registries; requirements;
7 penalties.--
8 (1) A nurse registry is exempt from the licensing
9 requirements of a home health agency but must be licensed as a
10 nurse registry. The requirements of part II of chapter 408
11 apply to the provision of services that require licensure
12 pursuant to ss. 400.506-400.518 and part II of chapter 408 and
13 to entities licensed by or applying for such license from the
14 Agency for Health Care Administration pursuant to ss.
15 400.506-400.518. A license issued by the agency is required
16 for the operation of a nurse registry. Each operational site
17 of the nurse registry must be licensed, unless there is more
18 than one site within a county. If there is more than one site
19 within a county, only one license per county is required. Each
20 operational site must be listed on the license.
21 (2) Each applicant for licensure and each licensee
22 must comply with all provisions of part II of chapter 408 and
23 this section. the following requirements:
24 (a) Upon receipt of a completed, signed, and dated
25 application, the agency shall require background screening, in
26 accordance with the level 2 standards for screening set forth
27 in chapter 435, of the managing employee, or other similarly
28 titled individual who is responsible for the daily operation
29 of the nurse registry, and of the financial officer, or other
30 similarly titled individual who is responsible for the
31 financial operation of the registry, including billings for
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1 patient care and services. The applicant shall comply with the
2 procedures for level 2 background screening as set forth in
3 chapter 435.
4 (b) The agency may require background screening of any
5 other individual who is an applicant if the agency has
6 probable cause to believe that he or she has been convicted of
7 a crime or has committed any other offense prohibited under
8 the level 2 standards for screening set forth in chapter 435.
9 (c) Proof of compliance with the level 2 background
10 screening requirements of chapter 435 which has been submitted
11 within the previous 5 years in compliance with any other
12 health care or assisted living licensure requirements of this
13 state is acceptable in fulfillment of the requirements of
14 paragraph (a).
15 (d) A provisional license may be granted to an
16 applicant when each individual required by this section to
17 undergo background screening has met the standards for the
18 Department of Law Enforcement background check but the agency
19 has not yet received background screening results from the
20 Federal Bureau of Investigation. A standard license may be
21 granted to the applicant upon the agency's receipt of a report
22 of the results of the Federal Bureau of Investigation
23 background screening for each individual required by this
24 section to undergo background screening which confirms that
25 all standards have been met, or upon the granting of a
26 disqualification exemption by the agency as set forth in
27 chapter 435. Any other person who is required to undergo level
28 2 background screening may serve in his or her capacity
29 pending the agency's receipt of the report from the Federal
30 Bureau of Investigation. However, the person may not continue
31 to serve if the report indicates any violation of background
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1 screening standards and a disqualification exemption has not
2 been requested of and granted by the agency as set forth in
3 chapter 435.
4 (e) Each applicant must submit to the agency, with its
5 application, a description and explanation of any exclusions,
6 permanent suspensions, or terminations of the applicant from
7 the Medicare or Medicaid programs. Proof of compliance with
8 the requirements for disclosure of ownership and control
9 interests under the Medicaid or Medicare programs may be
10 accepted in lieu of this submission.
11 (f) Each applicant must submit to the agency a
12 description and explanation of any conviction of an offense
13 prohibited under the level 2 standards of chapter 435 by a
14 member of the board of directors of the applicant, its
15 officers, or any individual owning 5 percent or more of the
16 applicant. This requirement does not apply to a director of a
17 not-for-profit corporation or organization if the director
18 serves solely in a voluntary capacity for the corporation or
19 organization, does not regularly take part in the day-to-day
20 operational decisions of the corporation or organization,
21 receives no remuneration for his or her services on the
22 corporation or organization's board of directors, and has no
23 financial interest and has no family members with a financial
24 interest in the corporation or organization, provided that the
25 director and the not-for-profit corporation or organization
26 include in the application a statement affirming that the
27 director's relationship to the corporation satisfies the
28 requirements of this paragraph.
29 (g) A license may not be granted to an applicant if
30 the applicant or managing employee has been found guilty of,
31 regardless of adjudication, or has entered a plea of nolo
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1 contendere or guilty to, any offense prohibited under the
2 level 2 standards for screening set forth in chapter 435,
3 unless an exemption from disqualification has been granted by
4 the agency as set forth in chapter 435.
5 (h) The agency may deny or revoke the license if any
6 applicant:
7 1. Has falsely represented a material fact in the
8 application required by paragraph (e) or paragraph (f), or has
9 omitted any material fact from the application required by
10 paragraph (e) or paragraph (f); or
11 2. Has had prior action taken against the applicant
12 under the Medicaid or Medicare program as set forth in
13 paragraph (e).
14 (i) An application for license renewal must contain
15 the information required under paragraphs (e) and (f).
16 (3) In accordance with s. 408.805, an applicant or
17 licensee shall pay a fee for each license application
18 submitted under ss. 400.508-400.518, part II of chapter 408,
19 and applicable rules. The amount of the fee shall be
20 established by rule and may not exceed $2,000 per biennium.
21 Application for license must be made to the Agency for Health
22 Care Administration on forms furnished by it and must be
23 accompanied by the appropriate licensure fee, as established
24 by rule and not to exceed the cost of regulation under this
25 part. The licensure fee for nurse registries may not exceed
26 $2,000 and must be deposited in the Health Care Trust Fund.
27 (4) The Agency for Health Care Administration may
28 deny, revoke, or suspend a license or impose an administrative
29 fine in the manner provided in chapter 120 against a nurse
30 registry that:
31
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1 (a) Fails to comply with this section or applicable
2 rules.
3 (b) Commits an intentional, reckless, or negligent act
4 that materially affects the health or safety of a person
5 receiving services.
6 (5) A license issued for the operation of a nurse
7 registry, unless sooner suspended or revoked, expires 2 years
8 after its date of issuance. Sixty days before the expiration
9 date, an application for renewal must be submitted to the
10 Agency for Health Care Administration on forms furnished by
11 it. The Agency for Health Care Administration shall renew the
12 license if the applicant has met the requirements of this
13 section and applicable rules. A nurse registry against which a
14 revocation or suspension proceeding is pending at the time of
15 license renewal may be issued a conditional license effective
16 until final disposition by the Agency for Health Care
17 Administration of such proceedings. If judicial relief is
18 sought from the final disposition, the court having
19 jurisdiction may issue a conditional license for the duration
20 of the judicial proceeding.
21 (6) The Agency for Health Care Administration may
22 institute injunctive proceedings under s. 400.515.
23 (4)(7) A person that provides, offers, or advertises
24 to the public any service for which licensure is required
25 under this section must include in such advertisement the
26 license number issued to it by the Agency for Health Care
27 Administration. The agency shall assess a fine of not less
28 than $100 against any licensee who fails to include the
29 license number when submitting the advertisement for
30 publication, broadcast, or printing. The fine for a second or
31 subsequent offense is $500.
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1 (8)(a) It is unlawful for a person to provide, offer,
2 or advertise to the public services as defined by rule without
3 obtaining a valid license from the Agency for Health Care
4 Administration. It is unlawful for any holder of a license to
5 advertise or hold out to the public that he or she holds a
6 license for other than that for which he or she actually holds
7 a license. A person who violates this subsection is subject to
8 injunctive proceedings under s. 400.515.
9 (b) A person who violates the provisions of paragraph
10 (a) commits a misdemeanor of the second degree, punishable as
11 provided in s. 775.082 or s. 775.083. Each day of continuing
12 violation is a separate offense.
13 (5)(a)(c) In addition to the requirements of s.
14 408.812, any person who owns, operates, or maintains an
15 unlicensed nurse registry and who, within 10 working days
16 after receiving notification from the agency, fails to cease
17 operation and apply for a license under this part commits a
18 misdemeanor of the second degree, punishable as provided in s.
19 775.082 or s. 775.083. Each day of continued operation is a
20 separate offense.
21 (b)(d) If a nurse registry fails to cease operation
22 after agency notification, the agency may impose a fine of
23 $500 for each day of noncompliance.
24 (9) Any duly authorized officer or employee of the
25 Agency for Health Care Administration may make such
26 inspections and investigations as are necessary to respond to
27 complaints or to determine the state of compliance with this
28 section and applicable rules.
29 (a) If, in responding to a complaint, an agent or
30 employee of the Agency for Health Care Administration has
31
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1 reason to believe that a crime has been committed, he or she
2 shall notify the appropriate law enforcement agency.
3 (b) If, in responding to a complaint, an agent or
4 employee of the Agency for Health Care Administration has
5 reason to believe that abuse, neglect, or exploitation has
6 occurred, according to the definitions in chapter 415, he or
7 she shall file a report under chapter 415.
8 (6)(10)(a) A nurse registry may refer for contract in
9 private residences registered nurses and licensed practical
10 nurses registered and licensed under part I of chapter 464,
11 certified nursing assistants certified under part II of
12 chapter 464, home health aides who present documented proof of
13 successful completion of the training required by rule of the
14 agency, and companions or homemakers for the purposes of
15 providing those services authorized under s. 400.509(1). Each
16 person referred by a nurse registry must provide current
17 documentation that he or she is free from communicable
18 diseases.
19 (b) A certified nursing assistant or home health aide
20 may be referred for a contract to provide care to a patient in
21 his or her home only if that patient is under a physician's
22 care. A certified nursing assistant or home health aide
23 referred for contract in a private residence shall be limited
24 to assisting a patient with bathing, dressing, toileting,
25 grooming, eating, physical transfer, and those normal daily
26 routines the patient could perform for himself or herself were
27 he or she physically capable. A certified nursing assistant or
28 home health aide may not provide medical or other health care
29 services that require specialized training and that may be
30 performed only by licensed health care professionals. The
31 nurse registry shall obtain the name and address of the
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1 attending physician and send written notification to the
2 physician within 48 hours after a contract is concluded that a
3 certified nursing assistant or home health aide will be
4 providing care for that patient.
5 (c) When a certified nursing assistant or home health
6 aide is referred to a patient's home by a nurse registry, the
7 nurse registry shall advise the patient, the patient's family,
8 or any other person acting on behalf of the patient at the
9 time the contract for services is made that registered nurses
10 are available to make visits to the patient's home for an
11 additional cost.
12 (7)(11) A person who is referred by a nurse registry
13 for contract in private residences and who is not a nurse
14 licensed under part I of chapter 464 may perform only those
15 services or care to clients that the person has been certified
16 to perform or trained to perform as required by law or rules
17 of the Agency for Health Care Administration or the Department
18 of Business and Professional Regulation. Providing services
19 beyond the scope authorized under this subsection constitutes
20 the unauthorized practice of medicine or a violation of the
21 Nurse Practice Act and is punishable as provided under chapter
22 458, chapter 459, or part I of chapter 464.
23 (8)(12) Each nurse registry must require every
24 applicant for contract to complete an application form
25 providing the following information:
26 (a) The name, address, date of birth, and social
27 security number of the applicant.
28 (b) The educational background and employment history
29 of the applicant.
30 (c) The number and date of the applicable license or
31 certification.
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1 (d) When appropriate, information concerning the
2 renewal of the applicable license, registration, or
3 certification.
4 (9)(13) Each nurse registry must comply with the
5 procedures set forth in s. 400.512 for maintaining records of
6 the work history of all persons referred for contract and is
7 subject to the standards and conditions set forth in that
8 section. However, an initial screening may not be required for
9 persons who have been continuously registered with the nurse
10 registry since October 1, 2000.
11 (10)(14) The nurse registry must maintain the
12 application on file, and that file must be open to the
13 inspection of the Agency for Health Care Administration. The
14 nurse registry must maintain on file the name and address of
15 the patient or client to whom nurse registry personnel are
16 referred for contract and the amount of the fee received by
17 the nurse registry. A nurse registry must maintain the file
18 that includes the application and other applicable
19 documentation for 3 years after the date of the last file
20 entry of patient-related or client-related information.
21 (11)(15) Nurse registries shall assist persons who
22 would need assistance and sheltering during evacuations
23 because of physical, mental, or sensory disabilities in
24 registering with the appropriate local emergency management
25 agency pursuant to s. 252.355.
26 (12)(16) Each nurse registry shall prepare and
27 maintain a comprehensive emergency management plan that is
28 consistent with the criteria in this subsection and with the
29 local special needs plan. The plan shall be updated annually.
30 The plan shall include the means by which the nurse registry
31 will continue to provide the same type and quantity of
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1 services to its patients who evacuate to special needs
2 shelters which were being provided to those patients prior to
3 evacuation. The plan shall specify how the nurse registry
4 shall facilitate the provision of continuous care by persons
5 referred for contract to persons who are registered pursuant
6 to s. 252.355 during an emergency that interrupts the
7 provision of care or services in private residences
8 residencies. Nurse registries may establish links to local
9 emergency operations centers to determine a mechanism by which
10 to approach specific areas within a disaster area in order for
11 a provider to reach its clients. Nurse registries shall
12 demonstrate a good faith effort to comply with the
13 requirements of this subsection by documenting attempts of
14 staff to follow procedures outlined in the nurse registry's
15 comprehensive emergency management plan which support a
16 finding that the provision of continuing care has been
17 attempted for patients identified as needing care by the nurse
18 registry and registered under s. 252.355 in the event of an
19 emergency under subsection (1).
20 (a) All persons referred for contract who care for
21 persons registered pursuant to s. 252.355 must include in the
22 patient record a description of how care will be continued
23 during a disaster or emergency that interrupts the provision
24 of care in the patient's home. It shall be the responsibility
25 of the person referred for contract to ensure that continuous
26 care is provided.
27 (b) Each nurse registry shall maintain a current
28 prioritized list of patients in private residences who are
29 registered pursuant to s. 252.355 and are under the care of
30 persons referred for contract and who need continued services
31 during an emergency. This list shall indicate, for each
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1 patient, if the client is to be transported to a special needs
2 shelter and if the patient is receiving skilled nursing
3 services. Nurse registries shall make this list available to
4 county health departments and to local emergency management
5 agencies upon request.
6 (c) Each person referred for contract who is caring
7 for a patient who is registered pursuant to s. 252.355 shall
8 provide a list of the patient's medication and equipment needs
9 to the nurse registry. Each person referred for contract shall
10 make this information available to county health departments
11 and to local emergency management agencies upon request.
12 (d) Each person referred for contract shall not be
13 required to continue to provide care to patients in emergency
14 situations that are beyond the person's control and that make
15 it impossible to provide services, such as when roads are
16 impassable or when patients do not go to the location
17 specified in their patient records.
18 (e) The comprehensive emergency management plan
19 required by this subsection is subject to review and approval
20 by the county health department. During its review, the county
21 health department shall contact state and local health and
22 medical stakeholders when necessary. The county health
23 department shall complete its review to ensure that the plan
24 complies with the criteria in the Agency for Health Care
25 Administration rules within 90 days after receipt of the plan
26 and shall either approve the plan or advise the nurse registry
27 of necessary revisions. If a nurse registry fails to submit a
28 plan or fails to submit requested information or revisions to
29 the county health department within 30 days after written
30 notification from the county health department, the county
31 health department shall notify the Agency for Health Care
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1 Administration. The agency shall notify the nurse registry
2 that its failure constitutes a deficiency, subject to a fine
3 of $5,000 per occurrence. If the plan is not submitted,
4 information is not provided, or revisions are not made as
5 requested, the agency may impose the fine.
6 (f) The Agency for Health Care Administration shall
7 adopt rules establishing minimum criteria for the
8 comprehensive emergency management plan and plan updates
9 required by this subsection, with the concurrence of the
10 Department of Health and in consultation with the Department
11 of Community Affairs.
12 (13)(17) All persons referred for contract in private
13 residences by a nurse registry must comply with the following
14 requirements for a plan of treatment:
15 (a) When, in accordance with the privileges and
16 restrictions imposed upon a nurse under part I of chapter 464,
17 the delivery of care to a patient is under the direction or
18 supervision of a physician or when a physician is responsible
19 for the medical care of the patient, a medical plan of
20 treatment must be established for each patient receiving care
21 or treatment provided by a licensed nurse in the home. The
22 original medical plan of treatment must be timely signed by
23 the physician, physician assistant, or advanced registered
24 nurse practitioner, acting within his or her respective scope
25 of practice, and reviewed in consultation with the licensed
26 nurse at least every 2 months. Any additional order or change
27 in orders must be obtained from the physician, physician
28 assistant, or advanced registered nurse practitioner and
29 reduced to writing and timely signed by the physician,
30 physician assistant, or advanced registered nurse
31 practitioner. The delivery of care under a medical plan of
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1 treatment must be substantiated by the appropriate nursing
2 notes or documentation made by the nurse in compliance with
3 nursing practices established under part I of chapter 464.
4 (b) Whenever a medical plan of treatment is
5 established for a patient, the initial medical plan of
6 treatment, any amendment to the plan, additional order or
7 change in orders, and copy of nursing notes must be filed in
8 the office of the nurse registry.
9 (14)(18) The nurse registry must comply with the
10 notice requirements of s. 408.810(5) s. 400.495, relating to
11 abuse reporting.
12 (15)(19) In addition to any other penalties imposed
13 pursuant to this section or part, the agency may assess costs
14 related to an investigation that results in a successful
15 prosecution, excluding costs associated with an attorney's
16 time. If the agency imposes such an assessment and the
17 assessment is not paid, and if challenged is not the subject
18 of a pending appeal, prior to the renewal of the license, the
19 license shall not be issued until the assessment is paid or
20 arrangements for payment of the assessment are made.
21 (16)(20) The Agency for Health Care Administration
22 shall adopt rules to implement this section and part II of
23 chapter 408.
24 Section 83. Section 400.509, Florida Statutes, is
25 amended to read:
26 400.509 Registration of particular service providers
27 exempt from licensure; certificate of registration; regulation
28 of registrants.--
29 (1) Any organization that provides companion services
30 or homemaker services and does not provide a home health
31 service to a person is exempt from licensure under this part.
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1 However, any organization that provides companion services or
2 homemaker services must register with the agency.
3 (2) The requirements of part II of chapter 408 apply
4 to the provision of services that require registration or
5 licensure pursuant to this section and part II of chapter 408
6 and entities registered by or applying for such registration
7 from the Agency for Health Care Administration pursuant to
8 this section. Each applicant for registration and each
9 registrant must comply with all provisions of part II of
10 chapter 408. Registration or a license issued by the agency is
11 required for the operation of an organization that provides
12 companion services or homemaker services. Registration
13 consists of annually filing with the agency, under oath, on
14 forms provided by it, the following information:
15 (a) If the registrant is a firm or partnership, the
16 name, address, date of birth, and social security number of
17 every member.
18 (b) If the registrant is a corporation or association,
19 its name and address; the name, address, date of birth, and
20 social security number of each of its directors and officers;
21 and the name and address of each person having at least a 5
22 percent interest in the corporation or association.
23 (c) The name, address, date of birth, and social
24 security number of each person employed by or under contract
25 with the organization.
26 (3) In accordance with s. 408.805, applicants and
27 registrants shall pay fees for all registrations issued under
28 this part, part II of chapter 408, and applicable rules. The
29 amount of the fee shall be $50 per biennium. The agency shall
30 charge a registration fee of $25 to be submitted with the
31 information required under subsection (2).
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1 (4) Each applicant for registration must comply with
2 the following requirements:
3 (a) Upon receipt of a completed, signed, and dated
4 application, the agency shall require background screening, in
5 accordance with the level 1 standards for screening set forth
6 in chapter 435, of every individual who will have contact with
7 the client. The agency shall require background screening of
8 the managing employee or other similarly titled individual who
9 is responsible for the operation of the entity, and of the
10 financial officer or other similarly titled individual who is
11 responsible for the financial operation of the entity,
12 including billings for client services in accordance with the
13 level 2 standards for background screening as set forth in
14 chapter 435.
15 (b) The agency may require background screening of any
16 other individual who is affiliated with the applicant if the
17 agency has a reasonable basis for believing that he or she has
18 been convicted of a crime or has committed any other offense
19 prohibited under the level 2 standards for screening set forth
20 in chapter 435.
21 (c) Proof of compliance with the level 2 background
22 screening requirements of chapter 435 which has been submitted
23 within the previous 5 years in compliance with any other
24 health care or assisted living licensure requirements of this
25 state is acceptable in fulfillment of paragraph (a).
26 (d) A provisional registration may be granted to an
27 applicant when each individual required by this section to
28 undergo background screening has met the standards for the
29 abuse-registry background check through the agency and the
30 Department of Law Enforcement background check, but the agency
31 has not yet received background screening results from the
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1 Federal Bureau of Investigation. A standard registration may
2 be granted to the applicant upon the agency's receipt of a
3 report of the results of the Federal Bureau of Investigation
4 background screening for each individual required by this
5 section to undergo background screening which confirms that
6 all standards have been met, or upon the granting of a
7 disqualification exemption by the agency as set forth in
8 chapter 435. Any other person who is required to undergo level
9 2 background screening may serve in his or her capacity
10 pending the agency's receipt of the report from the Federal
11 Bureau of Investigation. However, the person may not continue
12 to serve if the report indicates any violation of background
13 screening standards and if a disqualification exemption has
14 not been requested of and granted by the agency as set forth
15 in chapter 435.
16 (e) Each applicant must submit to the agency, with its
17 application, a description and explanation of any exclusions,
18 permanent suspensions, or terminations of the applicant from
19 the Medicare or Medicaid programs. Proof of compliance with
20 the requirements for disclosure of ownership and control
21 interests under the Medicaid or Medicare programs may be
22 accepted in lieu of this submission.
23 (f) Each applicant must submit to the agency a
24 description and explanation of any conviction of an offense
25 prohibited under the level 2 standards of chapter 435 which
26 was committed by a member of the board of directors of the
27 applicant, its officers, or any individual owning 5 percent or
28 more of the applicant. This requirement does not apply to a
29 director of a not-for-profit corporation or organization who
30 serves solely in a voluntary capacity for the corporation or
31 organization, does not regularly take part in the day-to-day
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1 operational decisions of the corporation or organization,
2 receives no remuneration for his or her services on the
3 corporation's or organization's board of directors, and has no
4 financial interest and no family members having a financial
5 interest in the corporation or organization, if the director
6 and the not-for-profit corporation or organization include in
7 the application a statement affirming that the director's
8 relationship to the corporation satisfies the requirements of
9 this paragraph.
10 (g) A registration may not be granted to an applicant
11 if the applicant or managing employee has been found guilty
12 of, regardless of adjudication, or has entered a plea of nolo
13 contendere or guilty to, any offense prohibited under the
14 level 2 standards for screening set forth in chapter 435,
15 unless an exemption from disqualification has been granted by
16 the agency as set forth in chapter 435.
17 (h) The agency may deny or revoke the registration of
18 any applicant who:
19 1. Has falsely represented a material fact in the
20 application required by paragraph (e) or paragraph (f), or has
21 omitted any material fact from the application required by
22 paragraph (e) or paragraph (f); or
23 2. Has had prior action taken against the applicant
24 under the Medicaid or Medicare program as set forth in
25 paragraph (e).
26 (i) An application for licensure renewal must contain
27 the information required under paragraphs (e) and (f).
28 (4)(5) Each registrant must obtain the employment or
29 contract history of persons who are employed by or under
30 contract with the organization and who will have contact at
31 any time with patients or clients in their homes by:
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1 (a) Requiring such persons to submit an employment or
2 contractual history to the registrant; and
3 (b) Verifying the employment or contractual history,
4 unless through diligent efforts such verification is not
5 possible. The agency shall prescribe by rule the minimum
6 requirements for establishing that diligent efforts have been
7 made.
8
9 There is no monetary liability on the part of, and no cause of
10 action for damages arises against, a former employer of a
11 prospective employee of or prospective independent contractor
12 with a registrant who reasonably and in good faith
13 communicates his or her honest opinions about the former
14 employee's or contractor's job performance. This subsection
15 does not affect the official immunity of an officer or
16 employee of a public corporation.
17 (6) On or before the first day on which services are
18 provided to a patient or client, any registrant under this
19 part must inform the patient or client and his or her
20 immediate family, if appropriate, of the right to report
21 abusive, neglectful, or exploitative practices. The statewide
22 toll-free telephone number for the central abuse hotline must
23 be provided to patients or clients in a manner that is clearly
24 legible and must include the words: "To report abuse, neglect,
25 or exploitation, please call toll-free (phone number) ."
26 Registrants must establish appropriate policies and
27 procedures for providing such notice to patients or clients.
28 (7) The provisions of s. 400.512 regarding screening
29 apply to any person or business entity registered under this
30 section on or after October 1, 1994.
31
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1 (8) Upon verification that all requirements for
2 registration have been met, the Agency for Health Care
3 Administration shall issue a certificate of registration valid
4 for no more than 1 year.
5 (9) The Agency for Health Care Administration may
6 deny, suspend, or revoke the registration of a person that:
7 (a) Fails to comply with this section or applicable
8 rules.
9 (b) Commits an intentional, reckless, or negligent act
10 that materially affects the health or safety of a person
11 receiving services.
12 (10) The Agency for Health Care Administration may
13 institute injunctive proceedings under s. 400.515.
14 (5)(11) A person that offers or advertises to the
15 public a service for which registration is required must
16 include in its advertisement the registration number issued by
17 the Agency for Health Care Administration.
18 (12) It is unlawful for a person to offer or advertise
19 to the public services, as defined by rule, without obtaining
20 a certificate of registration from the Agency for Health Care
21 Administration. It is unlawful for any holder of a certificate
22 of registration to advertise or hold out to the public that he
23 or she holds a certificate of registration for other than that
24 for which he or she actually holds a certificate of
25 registration. Any person who violates this subsection is
26 subject to injunctive proceedings under s. 400.515.
27 (13) Any duly authorized officer or employee of the
28 Agency for Health Care Administration has the right to make
29 such inspections and investigations as are necessary in order
30 to respond to complaints or to determine the state of
31 compliance with this section and applicable rules.
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1 (a) If, in responding to a complaint, an officer or
2 employee of the Agency for Health Care Administration has
3 reason to believe that a crime has been committed, he or she
4 shall notify the appropriate law enforcement agency.
5 (b) If, in responding to a complaint, an officer or
6 employee of the Agency for Health Care Administration has
7 reason to believe that abuse, neglect, or exploitation has
8 occurred, according to the definitions in chapter 415, he or
9 she shall file a report under chapter 415.
10 (6)(14) In addition to any other penalties imposed
11 pursuant to this section or part, the agency may assess costs
12 related to an investigation that results in a successful
13 prosecution, excluding costs associated with an attorney's
14 time. If the agency imposes such an assessment and the
15 assessment is not paid, and if challenged is not the subject
16 of a pending appeal, prior to the renewal of the registration,
17 the registration shall not be issued until the assessment is
18 paid or arrangements for payment of the assessment are made.
19 (7)(15) The Agency for Health Care Administration
20 shall adopt rules to administer this section and part II of
21 chapter 408.
22 Section 84. Subsection (7) of section 400.512, Florida
23 Statutes, is amended to read:
24 400.512 Screening of home health agency personnel;
25 nurse registry personnel; and companions and homemakers.--The
26 agency shall require employment or contractor screening as
27 provided in chapter 435, using the level 1 standards for
28 screening set forth in that chapter, for home health agency
29 personnel; persons referred for employment by nurse
30 registries; and persons employed by companion or homemaker
31 services registered under s. 400.509.
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1 (7)(a) It is a misdemeanor of the first degree,
2 punishable under s. 775.082 or s. 775.083, for any person
3 willfully, knowingly, or intentionally to:
4 1. Fail, by false statement, misrepresentation,
5 impersonation, or other fraudulent means, to disclose in any
6 application for voluntary or paid employment a material fact
7 used in making a determination as to such person's
8 qualifications to be an employee under this section;
9 2. Operate or attempt to operate an entity licensed or
10 registered under this part with persons who do not meet the
11 minimum standards for good moral character as contained in
12 this section; or
13 3. Use information from the criminal records obtained
14 under this section for any purpose other than screening that
15 person for employment as specified in this section or release
16 such information to any other person for any purpose other
17 than screening for employment under this section.
18 (b) It is a felony of the third degree, punishable
19 under s. 775.082, s. 775.083, or s. 775.084, for any person
20 willfully, knowingly, or intentionally to use information from
21 the juvenile records of a person obtained under this section
22 for any purpose other than screening for employment under this
23 section.
24 Section 85. Section 400.515, Florida Statutes, is
25 repealed.
26 Section 86. Section 400.602, Florida Statutes, is
27 amended to read:
28 400.602 Licensure required; prohibited acts;
29 exemptions; display, transferability of license.--
30 (1)(a) The requirements of part II of chapter 408
31 apply to the provision of services that require licensure
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1 pursuant to this part and part II of chapter 408 and to
2 entities licensed by or applying for such licensure from the
3 agency pursuant to this part. A license issued by the agency
4 is required in order to operate a hospice in this state It is
5 unlawful to operate or maintain a hospice without first
6 obtaining a license from the agency.
7 (b) It is unlawful for Any person or legal entity that
8 is not licensed as a hospice under this part may not to use
9 the word "hospice" in its name, or to offer or advertise
10 hospice services or hospice-like services in such a way as to
11 mislead a person to believe that the offeror is a hospice
12 licensed under this part.
13 (b)(c) It is unlawful for any person or legal entity
14 offering, describing, or advertising hospice services or
15 hospice-like services or otherwise holding itself out as a
16 hospice to do so without stating the year of initial licensure
17 as a hospice in the state or the year of initial licensure of
18 the hospice entity or affiliate based in the state that owns
19 the hospice. At a minimum, the year of initial licensure must
20 be stated directly beneath the name of the licensed entity in
21 a type no less than 25 percent of the size of the type used
22 for the name or other indication of hospice services or
23 hospice-like services and must be prominently stated at least
24 one time on any document, item, or other medium offering,
25 describing, or advertising hospice services or hospice-like
26 services. This requirement excludes any materials relating to
27 the care and treatment of an existing hospice patient.
28 (2) Services provided by a hospital, nursing home, or
29 other health care facility, health care provider, or
30 caregiver, or under the Community Care for the Elderly Act, do
31 not constitute a hospice unless the facility, provider, or
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1 caregiver establishes a separate and distinct administrative
2 program to provide home, residential, and homelike inpatient
3 hospice services.
4 (3)(a) A separately licensed hospice may not use a
5 name which is substantially the same as the name of another
6 hospice licensed under this part.
7 (b) A licensed hospice which intends to change its
8 name or address must notify the agency at least 60 days before
9 making the change.
10 (4) The license shall be displayed in a conspicuous
11 place inside the hospice program office; shall be valid only
12 in the possession of the person or public agency to which it
13 is issued; shall not be subject to sale, assignment, or other
14 transfer, voluntary or involuntary; and shall not be valid for
15 any hospice other than the hospice for which originally
16 issued.
17 Section 87. Section 400.605, Florida Statutes, is
18 amended to read:
19 400.605 Administration; forms; fees; rules;
20 inspections; fines.--
21 (1) The agency, in consultation with the department,
22 may adopt rules to administer the requirements of part II of
23 chapter 408. The department, in consultation with the agency,
24 shall by rule establish minimum standards and procedures for a
25 hospice pursuant to this part. The rules must include:
26 (a) License application procedures and requirements.
27 (a)(b) The qualifications of professional and
28 ancillary personnel to ensure the provision of appropriate and
29 adequate hospice care.
30 (b)(c) Standards and procedures for the administrative
31 management of a hospice.
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1 (c)(d) Standards for hospice services that ensure the
2 provision of quality patient care.
3 (d)(e) Components of a patient plan of care.
4 (e)(f) Procedures relating to the implementation of
5 advanced directives and do-not-resuscitate orders.
6 (f)(g) Procedures for maintaining and ensuring
7 confidentiality of patient records.
8 (g)(h) Standards for hospice care provided in
9 freestanding inpatient facilities that are not otherwise
10 licensed medical facilities and in residential care facilities
11 such as nursing homes, assisted living facilities, adult
12 family care homes, and hospice residential units and
13 facilities.
14 (h)(i) Components of a comprehensive emergency
15 management plan, developed in consultation with the Department
16 of Health, the Department of Elderly Affairs, and the
17 Department of Community Affairs.
18 (i)(j) Standards and procedures relating to the
19 establishment and activities of a quality assurance and
20 utilization review committee.
21 (j)(k) Components and procedures relating to the
22 collection of patient demographic data and other information
23 on the provision of hospice care in this state.
24 (2) In accordance with s. 408.805, an applicant or
25 licensee shall pay a fee for each license application
26 submitted under this part, part II of chapter 408, and
27 applicable rules. The amount of the fee shall be established
28 by rule and may not exceed $1,200 per biennium. The agency
29 shall:
30
31
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1 (a) Prepare and furnish all forms necessary under the
2 provisions of this part in relation to applications for
3 licensure or licensure renewals.
4 (b) Collect from the applicant at the time of filing
5 an application for a license or at the time of renewal of a
6 license a fee which must be reasonably calculated to cover the
7 cost of regulation under this part, but may not exceed $600
8 per program. All fees collected under this part shall be
9 deposited in the Health Care Trust Fund for the administration
10 of this part.
11 (c) Issue hospice licenses to all applicants which
12 meet the provisions of this part and applicable rules.
13 (3)(d) In accordance with s. 408.811, the agency shall
14 conduct annual licensure inspections of all licensees, except
15 that licensure inspections may be conducted biennially for
16 hospices having a 3-year record of substantial compliance.
17 (e) The agency shall conduct such inspections and
18 investigations as are necessary in order to determine the
19 state of compliance with the provisions of this part, part II
20 of chapter 408, and applicable adopted rules. The right of
21 inspection also extends to any program that the agency has
22 reason to believe is offering or advertising itself as a
23 hospice without a license, but no inspection may be made
24 without the permission of the owner or person in charge
25 thereof unless a warrant is first obtained from a circuit
26 court authorizing such inspection. An application for a
27 license or license renewal made pursuant to this part
28 constitutes permission for an inspection of the hospice for
29 which the license is sought in order to facilitate
30 verification of the information submitted on or in connection
31 with the application.
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1 (4)(f) In accordance with part II of chapter 408, the
2 agency may impose an administrative fine for any violation of
3 the provisions of this part, part II of chapter 408, or
4 applicable rules.
5 Section 88. Section 400.606, Florida Statutes, is
6 amended to read:
7 400.606 License; application; renewal; conditional
8 license or permit; certificate of need.--
9 (1) In addition to the requirements of part II of
10 chapter 408, A license application must be filed on a form
11 provided by the agency and must be accompanied by the
12 appropriate license fee as well as satisfactory proof that the
13 hospice is in compliance with this part and any rules adopted
14 by the department and proof of financial ability to operate
15 and conduct the hospice in accordance with the requirements of
16 this part. the initial application and change of ownership
17 application must be accompanied by a plan for the delivery of
18 home, residential, and homelike inpatient hospice services to
19 terminally ill persons and their families. Such plan must
20 contain, but need not be limited to:
21 (a) The estimated average number of terminally ill
22 persons to be served monthly.
23 (b) The geographic area in which hospice services will
24 be available.
25 (c) A listing of services which are or will be
26 provided, either directly by the applicant or through
27 contractual arrangements with existing providers.
28 (d) Provisions for the implementation of hospice home
29 care within 3 months after licensure.
30 (e) Provisions for the implementation of hospice
31 homelike inpatient care within 12 months after licensure.
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1 (f) The number and disciplines of professional staff
2 to be employed.
3 (g) The name and qualifications of any existing or
4 potential contractee.
5 (h) A plan for attracting and training volunteers.
6 (i) The projected annual operating cost of the
7 hospice.
8 (j) A statement of financial resources and personnel
9 available to the applicant to deliver hospice care.
10
11 If the applicant is an existing licensed health care provider,
12 the application must be accompanied by a copy of the most
13 recent profit-loss statement and, if applicable, the most
14 recent licensure inspection report.
15 (2) Each applicant must submit to the agency with its
16 application a description and explanation of any exclusions,
17 permanent suspensions, or terminations from the Medicaid or
18 Medicare programs of the owner, if an individual; of any
19 officer or board member of the hospice, if the owner is a
20 firm, corporation, partnership, or association; or of any
21 person owning 5 percent or more of the hospice. Proof of
22 compliance with disclosure of ownership and control interest
23 requirements of the Medicaid or Medicare programs may be
24 accepted in lieu of this submission.
25 (2)(3) In addition to the requirements of part II of
26 chapter 408, A license issued for the operation of a hospice,
27 unless sooner suspended or revoked, shall expire automatically
28 1 year from the date of issuance. Sixty days prior to the
29 expiration date, a hospice wishing to renew its license shall
30 submit an application for renewal to the agency on forms
31 furnished by the agency. The agency shall renew the license if
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1 the applicant has first met the requirements established under
2 this part and all applicable rules and has provided the
3 information described under this section in addition to the
4 application. However, the application for license renewal
5 shall be accompanied by an update of the plan for delivery of
6 hospice care only if information contained in the plan
7 submitted pursuant to subsection (1) is no longer applicable.
8 (4) A hospice against which a revocation or suspension
9 proceeding is pending at the time of license renewal may be
10 issued a conditional license by the agency effective until
11 final disposition of such proceeding. If judicial relief is
12 sought from the final agency action, the court having
13 jurisdiction may issue a conditional permit for the duration
14 of the judicial proceeding.
15 (3)(5) The agency shall not issue a license to a
16 hospice that fails to receive a certificate of need under the
17 provisions of part I of chapter 408 ss. 408.031-408.045. A
18 licensed hospice is a health care facility as that term is
19 used in s. 408.039(5) and is entitled to initiate or intervene
20 in an administrative hearing.
21 (4)(6) A freestanding hospice facility that is
22 primarily engaged in providing inpatient and related services
23 and that is not otherwise licensed as a health care facility
24 shall be required to obtain a certificate of need. However, a
25 freestanding hospice facility with six or fewer beds shall not
26 be required to comply with institutional standards such as,
27 but not limited to, standards requiring sprinkler systems,
28 emergency electrical systems, or special lavatory devices.
29 (5)(7) The agency may deny a license to an applicant
30 that fails to meet any condition for the provision of hospice
31 care or services imposed by the agency on a certificate of
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1 need by final agency action, unless the applicant can
2 demonstrate that good cause exists for the applicant's failure
3 to meet such condition.
4 Section 89. Section 400.6065, Florida Statutes, is
5 amended to read:
6 400.6065 Background screening.--
7 (1) Upon receipt of a completed application under s.
8 400.606, the agency shall require level 2 background screening
9 on each of the following persons, who shall be considered
10 employees for the purposes of conducting screening under
11 chapter 435:
12 (a) The hospice administrator and financial officer.
13 (b) An officer or board member if the hospice is a
14 firm, corporation, partnership, or association, or any person
15 owning 5 percent or more of the hospice if the agency has
16 probable cause to believe that such officer, board member, or
17 owner has been convicted of any offense prohibited by s.
18 435.04. For each officer, board member, or person owning 5
19 percent or more who has been convicted of any such offense,
20 the hospice shall submit to the agency a description and
21 explanation of the conviction at the time of license
22 application. This paragraph does not apply to a board member
23 of a not-for-profit corporation or organization if the board
24 member serves solely in a voluntary capacity, does not
25 regularly take part in the day-to-day operational decisions of
26 the corporation or organization, receives no remuneration for
27 his or her services, and has no financial interest and has no
28 family members with a financial interest in the corporation or
29 organization, provided that the board member and the
30 corporation or organization submit a statement affirming that
31
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1 the board member's relationship to the corporation or
2 organization satisfies the requirements of this paragraph.
3 (2) Proof of compliance with level 2 screening
4 standards which has been submitted within the previous 5 years
5 to meet any facility or professional licensure requirements of
6 the agency or the Department of Health satisfies the
7 requirements of this section.
8 (3) The agency may grant a provisional license to a
9 hospice applying for an initial license when each individual
10 required by this section to undergo screening has completed
11 the Department of Law Enforcement background check, but has
12 not yet received results from the Federal Bureau of
13 Investigation.
14 (4) The agency shall require employment or contractor
15 screening as provided in chapter 435, using the level 1
16 standards for screening set forth in that chapter, for hospice
17 personnel.
18 (5) The agency may grant exemptions from
19 disqualification from employment under this section as
20 provided in s. 435.07.
21 (6) The administration of each hospice must sign an
22 affidavit annually, under penalty of perjury, stating that all
23 personnel employed or contracted with on or after October 1,
24 1998, who provide hospice services in a facility, or who enter
25 the home of a patient in their service capacity, have been
26 screened.
27 (7) Proof of compliance with the screening
28 requirements of chapter 435 shall be accepted in lieu of the
29 requirements of this section if the person has been
30 continuously employed or registered without a breach in
31 service that exceeds 180 days, the proof of compliance is not
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1 more than 2 years old, and the person has been screened, at
2 the discretion of the hospice.
3 (8)(a) It is a misdemeanor of the first degree,
4 punishable under s. 775.082 or s. 775.083, for any person
5 willfully, knowingly, or intentionally to:
6 1. Fail, by false statement, misrepresentation,
7 impersonation, or other fraudulent means, to disclose in any
8 application for voluntary or paid employment a material fact
9 used in making a determination as to such person's
10 qualifications to be employed or contracted with under this
11 section;
12 2. Operate or attempt to operate an entity licensed
13 under this part with persons who do not meet the minimum
14 standards for good moral character as contained in this
15 section; or
16 3. Use information from the criminal records obtained
17 under this section for any purpose other than screening as
18 specified in this section, or release such information to any
19 other person for any purpose other than screening under this
20 section.
21 (b) It is a felony of the third degree, punishable
22 under s. 775.082, s. 775.083, or s. 775.084, for any person
23 willfully, knowingly, or intentionally to use information from
24 the juvenile records of a person obtained under this section
25 for any purpose other than screening for employment under this
26 section.
27 Section 90. Section 400.607, Florida Statutes, is
28 amended to read:
29 400.607 Denial, suspension, or revocation of license;
30 emergency actions; imposition of administrative fine; grounds;
31 injunctions.--
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1 (1) The agency may deny, revoke, and or suspend a
2 license, impose an action under s. 408.814, and or impose an
3 administrative fine, which may not exceed $5,000 per
4 violation, for the violation of any provision of this part,
5 part II of chapter 408, or applicable rules in the manner
6 provided in chapter 120.
7 (2) Any of the following actions by a licensed hospice
8 or any of its employees shall be grounds for action by the
9 agency against a hospice:
10 (a) A violation of the provisions of this part, part
11 II of chapter 408, or applicable rules.
12 (b) An intentional or negligent act materially
13 affecting the health or safety of a patient.
14 (3) The agency may deny or revoke a license upon a
15 determination that:
16 (a) Persons subject to level 2 background screening
17 under s. 400.6065 do not meet the screening standards of s.
18 435.04, and exemptions from disqualification have not been
19 provided by the agency.
20 (b) An officer, board member, or person owning 5
21 percent or more of the hospice has been excluded, permanently
22 suspended, or terminated from the Medicare or Medicaid
23 programs.
24 (3)(4) If, 3 months after the date of obtaining a
25 license, or at any time thereafter, a hospice does not have in
26 operation the home-care component of hospice care, the agency
27 shall immediately revoke the license of such hospice.
28 (4)(5) If, 12 months after the date of obtaining a
29 license pursuant to s. 400.606, or at any time thereafter, a
30 hospice does not have in operation the inpatient components of
31
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1 hospice care, the agency shall immediately revoke the license
2 of such hospice.
3 (6) The agency may institute a civil action in a court
4 of competent jurisdiction to seek injunctive relief to enforce
5 compliance with this part or any rule adopted pursuant to this
6 part.
7 (5)(7) The remedies set forth in this section are
8 independent of and cumulative to other remedies provided by
9 law.
10 Section 91. Subsection (8) of section 400.6095,
11 Florida Statutes, is amended to read:
12 400.6095 Patient admission; assessment; plan of care;
13 discharge; death.--
14 (8) The hospice care team may withhold or withdraw
15 cardiopulmonary resuscitation if presented with an order not
16 to resuscitate executed pursuant to s. 401.45. The department
17 shall adopt rules providing for the implementation of such
18 orders. Hospice staff shall not be subject to criminal
19 prosecution or civil liability, nor be considered to have
20 engaged in negligent or unprofessional conduct, for
21 withholding or withdrawing cardiopulmonary resuscitation
22 pursuant to such an order and applicable rules adopted by the
23 department. The absence of an order to resuscitate executed
24 pursuant to s. 401.45 does not preclude a physician from
25 withholding or withdrawing cardiopulmonary resuscitation as
26 otherwise permitted by law.
27 Section 92. Section 400.801, Florida Statutes, is
28 amended to read:
29 400.801 Homes for special services.--
30 (1) As used in this section, the term:
31
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1 (a) "Agency" means the "Agency for Health Care
2 Administration."
3 (b) "Home for special services" means a site licensed
4 by the agency prior to January 1, 2006, where specialized
5 health care services are provided, including personal and
6 custodial care, but not continuous nursing services.
7 (2) The requirements of part II of chapter 408 apply
8 to the provision of services that require licensure pursuant
9 to this section and part II of chapter 408 and entities
10 licensed by or applying for such licensure from the agency
11 pursuant to this section. A license issued by the agency is
12 required in order to operate a home for special services in
13 this state. A person must obtain a license from the agency to
14 operate a home for special services. A license is valid for 1
15 year.
16 (3) In accordance with s. 408.805, an applicant or
17 licensee shall pay a fee for each license application
18 submitted under this part, part II of chapter 408, and
19 applicable rules. The amount of the fee shall be established
20 by rule and may not be more than $2,000 per biennium. The
21 application for a license under this section must be made on a
22 form provided by the agency. A nonrefundable license fee of
23 not more than $1,000 must be submitted with the license
24 application.
25 (4) Each applicant for licensure must comply with the
26 following requirements:
27 (a) Upon receipt of a completed, signed, and dated
28 application, the agency shall require background screening, in
29 accordance with the level 2 standards for screening set forth
30 in chapter 435, of the managing employee, or other similarly
31 titled individual who is responsible for the daily operation
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1 of the facility, and of the financial officer, or other
2 similarly titled individual who is responsible for the
3 financial operation of the facility, including billings for
4 client care and services, in accordance with the level 2
5 standards for screening set forth in chapter 435. The
6 applicant must comply with the procedures for level 2
7 background screening as set forth in chapter 435.
8 (b) The agency may require background screening of any
9 other individual who is an applicant if the agency has
10 probable cause to believe that he or she has been convicted of
11 a crime or has committed any other offense prohibited under
12 the level 2 standards for screening set forth in chapter 435.
13 (c) Proof of compliance with the level 2 background
14 screening requirements of chapter 435 which has been submitted
15 within the previous 5 years in compliance with any other
16 health care or assisted living licensure requirements of this
17 state is acceptable in fulfillment of the requirements of
18 paragraph (a).
19 (d) A provisional license may be granted to an
20 applicant when each individual required by this section to
21 undergo background screening has met the standards for the
22 Department of Law Enforcement background check, but the agency
23 has not yet received background screening results from the
24 Federal Bureau of Investigation, or a request for a
25 disqualification exemption has been submitted to the agency as
26 set forth in chapter 435, but a response has not yet been
27 issued. A standard license may be granted to the applicant
28 upon the agency's receipt of a report of the results of the
29 Federal Bureau of Investigation background screening for each
30 individual required by this section to undergo background
31 screening which confirms that all standards have been met, or
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1 upon the granting of a disqualification exemption by the
2 agency as set forth in chapter 435. Any other person who is
3 required to undergo level 2 background screening may serve in
4 his or her capacity pending the agency's receipt of the report
5 from the Federal Bureau of Investigation. However, the person
6 may not continue to serve if the report indicates any
7 violation of background screening standards and a
8 disqualification exemption has not been requested of and
9 granted by the agency as set forth in chapter 435.
10 (e) Each applicant must submit to the agency, with its
11 application, a description and explanation of any exclusions,
12 permanent suspensions, or terminations of the applicant from
13 the Medicare or Medicaid programs. Proof of compliance with
14 the requirements for disclosure of ownership and control
15 interests under the Medicaid or Medicare programs may be
16 accepted in lieu of this submission.
17 (f) Each applicant must submit to the agency a
18 description and explanation of any conviction of an offense
19 prohibited under the level 2 standards of chapter 435 by a
20 member of the board of directors of the applicant, its
21 officers, or any individual owning 5 percent or more of the
22 applicant. This requirement does not apply to a director of a
23 not-for-profit corporation or organization if the director
24 serves solely in a voluntary capacity for the corporation or
25 organization, does not regularly take part in the day-to-day
26 operational decisions of the corporation or organization,
27 receives no remuneration for his or her services on the
28 corporation or organization's board of directors, and has no
29 financial interest and has no family members with a financial
30 interest in the corporation or organization, provided that the
31 director and the not-for-profit corporation or organization
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1 include in the application a statement affirming that the
2 director's relationship to the corporation satisfies the
3 requirements of this paragraph.
4 (g) A license may not be granted to an applicant if
5 the applicant or managing employee has been found guilty of,
6 regardless of adjudication, or has entered a plea of nolo
7 contendere or guilty to, any offense prohibited under the
8 level 2 standards for screening set forth in chapter 435,
9 unless an exemption from disqualification has been granted by
10 the agency as set forth in chapter 435.
11 (h) The agency may deny or revoke licensure if the
12 applicant:
13 1. Has falsely represented a material fact in the
14 application required by paragraph (e) or paragraph (f), or has
15 omitted any material fact from the application required by
16 paragraph (e) or paragraph (f); or
17 2. Has had prior action taken against the applicant
18 under the Medicaid or Medicare program as set forth in
19 paragraph (e).
20 (i) An application for license renewal must contain
21 the information required under paragraphs (e) and (f).
22 (5) Application for license renewal must be submitted
23 90 days before the expiration of the license.
24 (6) A change of ownership or control of a home for
25 special services must be reported to the agency in writing at
26 least 60 days before the change is scheduled to take effect.
27 (4)(7) The agency may shall adopt rules for
28 implementing and enforcing this section and part II of chapter
29 408.
30
31
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1 (8)(a) It is unlawful for any person to establish,
2 conduct, manage, or operate a home for special services
3 without obtaining a license from the agency.
4 (b) It is unlawful for any person to offer or
5 advertise to the public, in any medium whatever, specialized
6 health care services without obtaining a license from the
7 agency.
8 (c) It is unlawful for a holder of a license issued
9 under this section to advertise or represent to the public
10 that it holds a license for a type of facility other than the
11 facility for which its license is issued.
12 (5)(9)(a) In addition to the requirements of part II
13 of chapter 408, a violation of any provision of this section,
14 part II of chapter 408, or applicable rules adopted by the
15 agency for implementing this section is punishable by payment
16 of an administrative fine not to exceed $5,000.
17 (b) A violation of s. 408.812 subsection (8) or rules
18 adopted under that section subsection is a misdemeanor of the
19 first degree, punishable as provided in s. 775.082 or s.
20 775.083. Each day of continuing violation is a separate
21 offense.
22 Section 93. Section 400.805, Florida Statutes, is
23 amended to read:
24 400.805 Transitional living facilities.--
25 (1) As used in this section, the term:
26 (a) "Agency" means the Agency for Health Care
27 Administration.
28 (b) "Department" means the Department of Health.
29 (c) "Transitional living facility" means a site where
30 specialized health care services are provided, including, but
31 not limited to, rehabilitative services, community reentry
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1 training, aids for independent living, and counseling to
2 spinal-cord-injured persons and head-injured persons. This
3 term does not include a hospital licensed under chapter 395 or
4 any federally operated hospital or facility.
5 (2)(a) The requirements of part II of chapter 408
6 apply to the provision of services that require licensure
7 pursuant to this section and part II of chapter 408 and to
8 entities licensed by or applying for such licensure from the
9 agency pursuant to this section. A license issued by the
10 agency is required for the operation of a transitional living
11 facility in this state. A person must obtain a license from
12 the agency to operate a transitional living facility. A
13 license issued under this section is valid for 1 year.
14 (b) In accordance with this section, an applicant or a
15 licensee shall pay a fee for each license application
16 submitted under this part, part II of chapter 408, and
17 applicable rules. The fee shall consist of a $4,000 license
18 fee and a $78.50 per bed fee per biennium. The application for
19 a license must be made on a form provided by the agency. A
20 nonrefundable license fee of $2,000 and a fee of up to $39.25
21 per bed must be submitted with the license application.
22 (c) The agency may not issue a license to an applicant
23 until the agency receives notice from the department as
24 provided in paragraph (3)(6)(b).
25 (3) Each applicant for licensure must comply with the
26 following requirements:
27 (a) Upon receipt of a completed, signed, and dated
28 application, the agency shall require background screening, in
29 accordance with the level 2 standards for screening set forth
30 in chapter 435, of the managing employee, or other similarly
31 titled individual who is responsible for the daily operation
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1 of the facility, and of the financial officer, or other
2 similarly titled individual who is responsible for the
3 financial operation of the facility, including billings for
4 client care and services. The applicant must comply with the
5 procedures for level 2 background screening as set forth in
6 chapter 435.
7 (b) The agency may require background screening of any
8 other individual who is an applicant if the agency has
9 probable cause to believe that he or she has been convicted of
10 a crime or has committed any other offense prohibited under
11 the level 2 standards for screening set forth in chapter 435.
12 (c) Proof of compliance with the level 2 background
13 screening requirements of chapter 435 which has been submitted
14 within the previous 5 years in compliance with any other
15 health care or assisted living licensure requirements of this
16 state is acceptable in fulfillment of the requirements of
17 paragraph (a).
18 (d) A provisional license may be granted to an
19 applicant when each individual required by this section to
20 undergo background screening has met the standards for the
21 Department of Law Enforcement background check, but the agency
22 has not yet received background screening results from the
23 Federal Bureau of Investigation, or a request for a
24 disqualification exemption has been submitted to the agency as
25 set forth in chapter 435, but a response has not yet been
26 issued. A standard license may be granted to the applicant
27 upon the agency's receipt of a report of the results of the
28 Federal Bureau of Investigation background screening for each
29 individual required by this section to undergo background
30 screening which confirms that all standards have been met, or
31 upon the granting of a disqualification exemption by the
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1 agency as set forth in chapter 435. Any other person who is
2 required to undergo level 2 background screening may serve in
3 his or her capacity pending the agency's receipt of the report
4 from the Federal Bureau of Investigation. However, the person
5 may not continue to serve if the report indicates any
6 violation of background screening standards and a
7 disqualification exemption has not been requested of and
8 granted by the agency as set forth in chapter 435.
9 (e) Each applicant must submit to the agency, with its
10 application, a description and explanation of any exclusions,
11 permanent suspensions, or terminations of the applicant from
12 the Medicare or Medicaid programs. Proof of compliance with
13 the requirements for disclosure of ownership and control
14 interests under the Medicaid or Medicare programs may be
15 accepted in lieu of this submission.
16 (f) Each applicant must submit to the agency a
17 description and explanation of any conviction of an offense
18 prohibited under the level 2 standards of chapter 435 by a
19 member of the board of directors of the applicant, its
20 officers, or any individual owning 5 percent or more of the
21 applicant. This requirement does not apply to a director of a
22 not-for-profit corporation or organization if the director
23 serves solely in a voluntary capacity for the corporation or
24 organization, does not regularly take part in the day-to-day
25 operational decisions of the corporation or organization,
26 receives no remuneration for his or her services on the
27 corporation or organization's board of directors, and has no
28 financial interest and has no family members with a financial
29 interest in the corporation or organization, provided that the
30 director and the not-for-profit corporation or organization
31 include in the application a statement affirming that the
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1 director's relationship to the corporation satisfies the
2 requirements of this paragraph.
3 (g) A license may not be granted to an applicant if
4 the applicant or managing employee has been found guilty of,
5 regardless of adjudication, or has entered a plea of nolo
6 contendere or guilty to, any offense prohibited under the
7 level 2 standards for screening set forth in chapter 435,
8 unless an exemption from disqualification has been granted by
9 the agency as set forth in chapter 435.
10 (h) The agency may deny or revoke licensure if the
11 applicant:
12 1. Has falsely represented a material fact in the
13 application required by paragraph (e) or paragraph (f), or has
14 omitted any material fact from the application required by
15 paragraph (e) or paragraph (f); or
16 2. Has had prior action taken against the applicant
17 under the Medicaid or Medicare program as set forth in
18 paragraph (e).
19 (i) An application for license renewal must contain
20 the information required under paragraphs (e) and (f).
21 (4) An application for renewal of license must be
22 submitted 90 days before the expiration of the license. Upon
23 renewal of licensure, each applicant must submit to the
24 agency, under penalty of perjury, an affidavit as set forth in
25 paragraph (3)(d).
26 (5) A change of ownership or control of a transitional
27 living facility must be reported to the agency in writing at
28 least 60 days before the change is scheduled to take effect.
29 (3)(6)(a) The agency shall adopt rules in consultation
30 with the department governing the physical plant of
31
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1 transitional living facilities and the fiscal management of
2 transitional living facilities.
3 (b) The department shall adopt rules in consultation
4 with the agency governing the services provided to clients of
5 transitional living facilities. The department shall enforce
6 all requirements for providing services to the facility's
7 clients. The department must notify the agency when it
8 determines that an applicant for licensure meets the service
9 requirements adopted by the department.
10 (c) The agency and the department shall enforce
11 requirements under this section and part II of chapter 408, as
12 such requirements relate to them respectively, and their
13 respective adopted rules.
14 (7)(a) It is unlawful for any person to establish,
15 conduct, manage, or operate a transitional living facility
16 without obtaining a license from the agency.
17 (b) It is unlawful for any person to offer or
18 advertise to the public, in any medium whatever, services or
19 care defined in paragraph (1)(c) without obtaining a license
20 from the agency.
21 (c) It is unlawful for a holder of a license issued
22 under this section to advertise or represent to the public
23 that it holds a license for a type of facility other than the
24 facility for which its license is issued.
25 (4)(8) In accordance with s. 408.811, any designated
26 officer or employee of the agency, of the state, or of the
27 local fire marshal may enter unannounced upon and into the
28 premises of any facility licensed under this section in order
29 to determine the state of compliance with this section, part
30 II of chapter 408, and applicable rules and the rules or
31 standards in force under this section. The right of entry and
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1 inspection also extends to any premises that the agency has
2 reason to believe are being operated or maintained as a
3 facility without a license; but such an entry or inspection
4 may not be made without the permission of the owner or person
5 in charge of the facility unless a warrant that authorizes the
6 entry is first obtained from the circuit court. The warrant
7 requirement extends only to a facility that the agency has
8 reason to believe is being operated or maintained as a
9 facility without a license. An application for a license or
10 renewal thereof which is made under this section constitutes
11 permission for, and acquiescence in, any entry or inspection
12 of the premises for which the license is sought, in order to
13 facilitate verification of the information submitted on or in
14 connection with the application; to discover, investigate, and
15 determine the existence of abuse or neglect; or to elicit,
16 receive, respond to, and resolve complaints. A current valid
17 license constitutes unconditional permission for, and
18 acquiescence in, any entry or inspection of the premises by
19 authorized personnel. The agency retains the right of entry
20 and inspection of facilities that have had a license revoked
21 or suspended within the previous 24 months, to ensure that the
22 facility is not operating unlawfully. However, before the
23 facility is entered, a statement of probable cause must be
24 filed with the director of the agency, who must approve or
25 disapprove the action within 48 hours. Probable cause
26 includes, but is not limited to, evidence that the facility
27 holds itself out to the public as a provider of personal
28 assistance services, or the receipt by the advisory council on
29 brain and spinal cord injuries of a complaint about the
30 facility.
31
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1 (9) The agency may institute injunctive proceedings in
2 a court of competent jurisdiction for temporary or permanent
3 relief to:
4 (a) Enforce this section or any minimum standard,
5 rule, or order issued pursuant thereto if the agency's effort
6 to correct a violation through administrative fines has failed
7 or when the violation materially affects the health, safety,
8 or welfare of residents; or
9 (b) Terminate the operation of a facility if a
10 violation of this section or of any standard or rule adopted
11 pursuant thereto exists which materially affects the health,
12 safety, or welfare of residents.
13
14 The Legislature recognizes that, in some instances, action is
15 necessary to protect residents of facilities from immediately
16 life-threatening situations. If it appears by competent
17 evidence or a sworn, substantiated affidavit that a temporary
18 injunction should issue, the court, pending the determination
19 on final hearing, shall enjoin operation of the facility.
20 (10) The agency may impose an immediate moratorium on
21 admissions to a facility when the agency determines that any
22 condition in the facility presents a threat to the health,
23 safety, or welfare of the residents in the facility. If a
24 facility's license is denied, revoked, or suspended, the
25 facility may be subject to the immediate imposition of a
26 moratorium on admissions to run concurrently with licensure
27 denial, revocation, or suspension.
28 (5)(11)(a) In accordance with part II of chapter 408,
29 a violation of any provision of this section, part II of
30 chapter 408, or applicable rules adopted by the agency or
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1 department under this section is punishable by payment of an
2 administrative or a civil penalty fine not to exceed $5,000.
3 (b) Unlicensed activity pursuant to s. 408.812 A
4 violation of subsection (7) or rules adopted under that
5 subsection is a misdemeanor of the first degree, punishable as
6 provided in s. 775.082 or s. 775.083. Each day of a continuing
7 violation is a separate offense.
8 (6) The agency may adopt rules to administer the
9 requirements of part II of chapter 408.
10 Section 94. Subsection (4) of section 400.902, Florida
11 Statutes, is amended to read:
12 400.902 Definitions.--As used in this part, the term:
13 (4) "Owner or operator" means a licensee any
14 individual who has general administrative charge of a PPEC
15 center.
16 Section 95. Subsection (3) is added to section
17 400.903, Florida Statutes, to read:
18 400.903 PPEC centers to be licensed; exemptions.--
19 (3) The requirements of part II of chapter 408 apply
20 to the provision of services that require licensure pursuant
21 to this part and part II of chapter 408 and to entities
22 licensed by or applying for such licensure from the agency
23 pursuant to this part. A license issued by the agency is
24 required for the operation of a PPEC center in this state.
25 Section 96. Section 400.905, Florida Statutes, is
26 amended to read:
27 400.905 License required; fee; exemption; display.--
28 (1)(a) It is unlawful to operate or maintain a PPEC
29 center without first obtaining from the agency a license
30 authorizing such operation. The agency is responsible for
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1 licensing PPEC centers in accordance with the provisions of
2 this part.
3 (b) Any person who violates paragraph (a) is guilty of
4 a felony of the third degree, punishable as provided in s.
5 775.082, s. 775.083, or s. 775.084.
6 (1)(2) In addition to the requirements of part II of
7 chapter 408, separate licenses are required for PPEC centers
8 maintained on separate premises, even though they are operated
9 under the same management. Separate licenses are not required
10 for separate buildings on the same grounds.
11 (2)(3) In accordance with s. 408.805, an applicant or
12 licensee shall pay a fee for each license application
13 submitted under this part, part II of chapter 408, and
14 applicable rules. The amount of the fee shall be established
15 by rule and may not be less than $1,000 or more than $3,000
16 per biennium. The annual license fee required of a PPEC center
17 shall be in an amount determined by the agency to be
18 sufficient to cover the agency's costs in carrying out its
19 responsibilities under this part, but shall not be less than
20 $500 or more than $1,500.
21 (3)(4) County-operated or municipally operated PPEC
22 centers applying for licensure under this part are exempt from
23 the payment of license fees.
24 (5) The license shall be displayed in a conspicuous
25 place inside the PPEC center.
26 (6) A license shall be valid only in the possession of
27 the individual, firm, partnership, association, or corporation
28 to whom it is issued and shall not be subject to sale,
29 assignment, or other transfer, voluntary or involuntary; nor
30 shall a license be valid for any premises other than that for
31 which originally issued.
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1 (7) Any license granted by the agency shall state the
2 maximum capacity of the facility, the date the license was
3 issued, the expiration date of the license, and any other
4 information deemed necessary by the agency.
5 Section 97. Section 400.906, Florida Statutes, is
6 amended to read:
7 400.906 Initial application for license; zoning.--
8 (1) Application for a license shall be made to the
9 agency on forms furnished by it and shall be accompanied by
10 the appropriate license fee unless the applicant is exempt
11 from payment of the fee as provided in s. 400.905.
12 (2) In addition to the requirements of part II of
13 chapter 408, the application must shall be under oath and
14 shall contain the following:
15 (a) The name and address of the applicant and the name
16 by which the facility is to be known. Pursuant thereto:
17 1. If the applicant is a firm, partnership, or
18 association, the application shall contain the name and
19 address of every member thereof.
20 2. If the applicant is a corporation, the application
21 shall contain its name and address, the names and addresses of
22 its directors and officers, and the name and address of each
23 person having at least a 10 percent interest in the
24 corporation.
25 (b) Information which provides a source to establish
26 the suitable character and competency of the applicant in
27 accordance with the provisions of s. 402.305(2) and, if
28 applicable, of the owner or operator, including the name and
29 address of any licensed facility with which the applicant or
30 owner or operator has been affiliated through ownership or
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1 employment within 5 years of the date of the application for a
2 license.
3 (c) The names and addresses of other persons of whom
4 the agency may inquire as to the character and reputation of
5 the applicant and, if applicable, of the owner or operator.
6 (d) The names and addresses of other persons of whom
7 the agency may inquire as to the financial responsibility of
8 the applicant.
9 (e) Such other reasonable information as may be
10 required by the agency to evaluate the ability of the
11 applicant to meet the responsibilities entailed under this
12 part.
13 (f) The location of the facility for which a license
14 is sought and documentation, signed by the appropriate local
15 government official, which states that the applicant has met
16 local zoning requirements.
17 (3) The applicant for licensure shall furnish
18 satisfactory proof of financial ability to operate and conduct
19 the PPEC center in accordance with the requirements of this
20 part.
21 (4) The applicant for licensure shall furnish proof of
22 adequate liability insurance coverage or protection.
23 (5) Each applicant for licensure must comply with the
24 following requirements:
25 (a) Upon receipt of a completed, signed, and dated
26 application, the agency shall require background screening, in
27 accordance with the level 2 standards for screening set forth
28 in chapter 435, of the operator, and of the financial officer,
29 or other similarly titled individual who is responsible for
30 the financial operation of the center, including billings for
31 patient care and services. The applicant must comply with the
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1 procedures for level 2 background screening as set forth in
2 chapter 435, as well as the requirements of s. 435.03(3).
3 (b) The agency may require background screening of any
4 other individual who is an applicant if the agency has a
5 reasonable basis for believing that he or she has been
6 convicted of a crime or has committed any other offense
7 prohibited under the level 2 standards for screening set forth
8 in chapter 435.
9 (c) Proof of compliance with the level 2 background
10 screening requirements of chapter 435 which has been submitted
11 within the previous 5 years in compliance with any other
12 health care licensure requirements of this state is acceptable
13 in fulfillment of the requirements of paragraph (a).
14 (d) A provisional license may be granted to an
15 applicant when each individual required by this section to
16 undergo background screening has met the standards for the
17 Department of Law Enforcement background check, but the agency
18 has not yet received background screening results from the
19 Federal Bureau of Investigation, or a request for a
20 disqualification exemption has been submitted to the agency as
21 set forth in chapter 435, but a response has not yet been
22 issued. A standard license may be granted to the applicant
23 upon the agency's receipt of a report of the results of the
24 Federal Bureau of Investigation background screening for each
25 individual required by this section to undergo background
26 screening which confirms that all standards have been met, or
27 upon the granting of a disqualification exemption by the
28 agency as set forth in chapter 435. Any other person who is
29 required to undergo level 2 background screening may serve in
30 his or her capacity pending the agency's receipt of the report
31 from the Federal Bureau of Investigation. However, the person
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1 may not continue to serve if the report indicates any
2 violation of background screening standards and a
3 disqualification exemption has not been requested of and
4 granted by the agency as set forth in chapter 435.
5 (e) Each applicant must submit to the agency, with its
6 application, a description and explanation of any exclusions,
7 permanent suspensions, or terminations of the applicant from
8 the Medicare or Medicaid programs. Proof of compliance with
9 the requirements for disclosure of ownership and control
10 interests under the Medicaid or Medicare programs shall be
11 accepted in lieu of this submission.
12 (f) Each applicant must submit to the agency a
13 description and explanation of any conviction of an offense
14 prohibited under the level 2 standards of chapter 435 by a
15 member of the board of directors of the applicant, its
16 officers, or any individual owning 5 percent or more of the
17 applicant. This requirement does not apply to a director of a
18 not-for-profit corporation or organization if the director
19 serves solely in a voluntary capacity for the corporation or
20 organization, does not regularly take part in the day-to-day
21 operational decisions of the corporation or organization,
22 receives no remuneration for his or her services on the
23 corporation or organization's board of directors, and has no
24 financial interest and has no family members with a financial
25 interest in the corporation or organization, provided that the
26 director and the not-for-profit corporation or organization
27 include in the application a statement affirming that the
28 director's relationship to the corporation satisfies the
29 requirements of this paragraph.
30 (g) A license may not be granted to an applicant if
31 the applicant or managing employee has been found guilty of,
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1 regardless of adjudication, or has entered a plea of nolo
2 contendere or guilty to, any offense prohibited under the
3 level 2 standards for screening set forth in chapter 435,
4 unless an exemption from disqualification has been granted by
5 the agency as set forth in chapter 435.
6 (h) The agency may deny or revoke licensure if the
7 applicant:
8 1. Has falsely represented a material fact in the
9 application required by paragraph (e) or paragraph (f), or has
10 omitted any material fact from the application required by
11 paragraph (e) or paragraph (f); or
12 2. Has had prior action taken against the applicant
13 under the Medicaid or Medicare program as set forth in
14 paragraph (e).
15 (i) An application for license renewal must contain
16 the information required under paragraphs (e) and (f).
17 Section 98. Section 400.907, Florida Statutes, is
18 amended to read:
19 400.907 Denial, suspension, revocation of licensure;
20 administrative fines; grounds.--
21 (1) In accordance with part II of chapter 408, the
22 agency may deny, revoke, and or suspend a license and or
23 impose an administrative fine for the violation of any
24 provision of this part, part II of chapter 408, or applicable
25 rules in the manner provided in chapter 120.
26 (2) Any of the following actions by a PPEC center or
27 its employee is grounds for action by the agency against a
28 PPEC center or its employee:
29 (a) An intentional or negligent act materially
30 affecting the health or safety of children in the PPEC center.
31
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1 (b) A violation of the provisions of this part, part
2 II of chapter 408, or applicable rules or of any standards or
3 rules adopted pursuant to this part.
4 (c) Multiple and repeated violations of this part or
5 part II of chapter 408 or of minimum standards or rules
6 adopted pursuant to this part or part II of chapter 408.
7 (3) The agency shall be responsible for all
8 investigations and inspections conducted pursuant to this
9 part.
10 Section 99. Section 400.908, Florida Statutes, is
11 amended to read:
12 400.908 Administrative fines; disposition of fees and
13 fines.--
14 (1)(a) If the agency determines that a PPEC center is
15 being operated without a license or is otherwise not in
16 compliance with rules adopted under this part, part II of
17 chapter 408, or applicable rules, the agency, notwithstanding
18 any other administrative action it takes, shall make a
19 reasonable attempt to discuss each violation and recommended
20 corrective action with the owner of the PPEC center prior to
21 written notification thereof. The agency may request that the
22 PPEC center submit a corrective action plan that which
23 demonstrates a good faith effort to remedy each violation by a
24 specific date, subject to the approval of the agency.
25 (b) In accordance with part II of chapter 408, the
26 agency may fine a PPEC center or employee found in violation
27 of rules adopted pursuant to this part, part II of chapter
28 408, or applicable rules, in an amount not to exceed $500 for
29 each violation. Such fine may not exceed $5,000 in the
30 aggregate.
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1 (c) The failure to correct a violation by the date set
2 by the agency, or the failure to comply with an approved
3 corrective action plan, is a separate violation for each day
4 such failure continues, unless the agency approves an
5 extension to a specific date.
6 (d) If a PPEC center desires to appeal any agency
7 action under this section and the fine is upheld, the violator
8 shall pay the fine, plus interest at the legal rate specified
9 in s. 687.01, for each day beyond the date set by the agency
10 for payment of the fine.
11 (2) In determining if a fine is to be imposed and in
12 fixing the amount of any fine, the agency shall consider the
13 following factors:
14 (a) The gravity of the violation, including the
15 probability that death or serious physical or emotional harm
16 to a child will result or has resulted, the severity of the
17 actual or potential harm, and the extent to which the
18 provisions of the applicable statutes or rules were violated.
19 (b) Actions taken by the owner or operator to correct
20 violations.
21 (c) Any previous violations.
22 (d) The financial benefit to the PPEC center of
23 committing or continuing the violation.
24 (3) Fees and fines received by the agency under this
25 part shall be deposited in the Health Care Trust Fund created
26 in s. 408.16.
27 Section 100. Section 400.910, Florida Statutes, is
28 repealed.
29 Section 101. Section 400.911, Florida Statutes, is
30 repealed.
31
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1 Section 102. Section 400.912, Florida Statutes, is
2 amended to read:
3 400.912 Closing of a PPEC center.--
4 (1) Whenever a PPEC center voluntarily discontinues
5 operation, it shall, inform the agency in writing at least 30
6 days before the discontinuance of operation. The PPEC center
7 shall also, at such time, inform each child's legal guardian
8 of the fact and the proposed time of such discontinuance.
9 (2) Immediately upon discontinuance of the operation
10 of a PPEC center, the owner or operator shall surrender the
11 license therefor to the agency and the license shall be
12 canceled.
13 Section 103. Section 400.913, Florida Statutes, is
14 repealed.
15 Section 104. Subsection (1) of section 400.914,
16 Florida Statutes, is amended to read:
17 400.914 Rules establishing standards.--
18 (1) Pursuant to the intention of the Legislature to
19 provide safe and sanitary facilities and healthful programs,
20 the agency in conjunction with the Division of Children's
21 Medical Services Prevention and Intervention of the Department
22 of Health shall adopt and publish rules to implement the
23 provisions of this part and part II of chapter 408, which
24 shall include reasonable and fair standards. Any conflict
25 between these standards and those that may be set forth in
26 local, county, or city ordinances shall be resolved in favor
27 of those having statewide effect. Such standards shall relate
28 to:
29 (a) The assurance that PPEC services are family
30 centered and provide individualized medical, developmental,
31 and family training services.
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1 (b) The maintenance of PPEC centers, not in conflict
2 with the provisions of chapter 553 and based upon the size of
3 the structure and number of children, relating to plumbing,
4 heating, lighting, ventilation, and other building conditions,
5 including adequate space, which will ensure the health,
6 safety, comfort, and protection from fire of the children
7 served.
8 (c) The appropriate provisions of the most recent
9 edition of the "Life Safety Code" (NFPA-101) shall be applied.
10 (d) The number and qualifications of all personnel who
11 have responsibility for the care of the children served.
12 (e) All sanitary conditions within the PPEC center and
13 its surroundings, including water supply, sewage disposal,
14 food handling, and general hygiene, and maintenance thereof,
15 which will ensure the health and comfort of children served.
16 (f) Programs and basic services promoting and
17 maintaining the health and development of the children served
18 and meeting the training needs of the children's legal
19 guardians.
20 (g) Supportive, contracted, other operational, and
21 transportation services.
22 (h) Maintenance of appropriate medical records, data,
23 and information relative to the children and programs. Such
24 records shall be maintained in the facility for inspection by
25 the agency.
26 Section 105. Subsection (3) of section 400.915,
27 Florida Statutes, is amended to read:
28 400.915 Construction and renovation;
29 requirements.--The requirements for the construction or
30 renovation of a PPEC center shall comply with:
31
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1 (3) The standards or rules adopted pursuant to this
2 part and part II of chapter 408.
3 Section 106. Section 400.916, Florida Statutes, is
4 amended to read:
5 400.916 Prohibited acts; penalty for violation.--
6 (1) It is unlawful for any person or public body to
7 offer or advertise to the public, in any way or by any medium,
8 basic services as defined in this part without obtaining a
9 valid current license. It is unlawful for any holder of a
10 license issued pursuant to this part to advertise or hold out
11 to the public that it holds a license for a PPEC center other
12 than that for which it actually holds a license.
13 (2) Any person who violates s. 408.812 commits the
14 provisions of subsection (1) is guilty of a misdemeanor of the
15 second degree, punishable as provided in s. 775.083. Each day
16 of continuing violation is shall be considered a separate
17 offense.
18 Section 107. Section 400.917, Florida Statutes, is
19 repealed.
20 Section 108. Section 400.925, Florida Statutes, is
21 amended to read:
22 400.925 Definitions.--As used in this part, the term:
23 (1) "Accrediting organizations" means the Joint
24 Commission on Accreditation of Healthcare Organizations or
25 other national accreditation agencies whose standards for
26 accreditation are comparable to those required by this part
27 for licensure.
28 (2) "Affiliated person" means any person who directly
29 or indirectly manages, controls, or oversees the operation of
30 a corporation or other business entity that is a licensee,
31
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1 regardless of whether such person is a partner, shareholder,
2 owner, officer, director, agent, or employee of the entity.
3 (2)(3) "Agency" means the Agency for Health Care
4 Administration.
5 (4) "Applicant" means an individual applicant in the
6 case of a sole proprietorship, or any officer, director,
7 agent, managing employee, general manager, or affiliated
8 person, or any partner or shareholder having an ownership
9 interest equal to 5 percent or greater in the corporation,
10 partnership, or other business entity.
11 (3)(5) "Consumer" or "patient" means any person who
12 uses home medical equipment in his or her place of residence.
13 (4)(6) "Department" means the Department of Children
14 and Family Services.
15 (5)(7) "General manager" means the individual who has
16 the general administrative charge of the premises of a
17 licensed home medical equipment provider.
18 (6)(8) "Home medical equipment" includes any product
19 as defined by the Federal Drug Administration's Drugs, Devices
20 and Cosmetics Act, any products reimbursed under the Medicare
21 Part B Durable Medical Equipment benefits, or any products
22 reimbursed under the Florida Medicaid durable medical
23 equipment program. Home medical equipment includes oxygen and
24 related respiratory equipment; manual, motorized, or
25 customized wheelchairs and related seating and positioning,
26 but does not include prosthetics or orthotics or any splints,
27 braces, or aids custom fabricated by a licensed health care
28 practitioner; motorized scooters; personal transfer systems;
29 and specialty beds, for use by a person with a medical need.
30
31
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1 (7)(9) "Home medical equipment provider" means any
2 person or entity that sells or rents or offers to sell or rent
3 to or for a consumer:
4 (a) Any home medical equipment and services; or
5 (b) Home medical equipment that requires any home
6 medical equipment services.
7 (8)(10) "Home medical equipment provider personnel"
8 means persons who are employed by or under contract with a
9 home medical equipment provider.
10 (9)(11) "Home medical equipment services" means
11 equipment management and consumer instruction, including
12 selection, delivery, setup, and maintenance of equipment, and
13 other related services for the use of home medical equipment
14 in the consumer's regular or temporary place of residence.
15 (12) "Licensee" means the person or entity to whom a
16 license to operate as a home medical equipment provider is
17 issued by the agency.
18 (10)(13) "Life-supporting or life-sustaining
19 equipment" means a device that is essential to, or that yields
20 information that is essential to, the restoration or
21 continuation of a bodily function important to the
22 continuation of human life. Life-supporting or life-sustaining
23 equipment includes apnea monitors, enteral feeding pumps,
24 infusion pumps, portable home dialysis equipment, and
25 ventilator equipment and supplies for all related equipment,
26 including oxygen equipment and related respiratory equipment.
27 (11)(14) "Moratorium" means a mandated temporary
28 cessation or suspension of the sale, rental, or offering of
29 equipment after the imposition of the moratorium, in
30 accordance with part II of chapter 408. Services related to
31 equipment sold or rented prior to the moratorium must be
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1 continued without interruption, unless determined deemed
2 otherwise by the agency.
3 (15) "Person" means any individual, firm, partnership,
4 corporation, or association.
5 (12)(16) "Premises" means those buildings and
6 equipment which are located at the address of the licensed
7 home medical equipment provider for the provision of home
8 medical equipment services, which are in such reasonable
9 proximity as to appear to the public to be a single provider
10 location, and which comply with zoning ordinances.
11 (13)(17) "Residence" means the consumer's home or
12 place of residence, which may include nursing homes, assisted
13 living facilities, transitional living facilities, adult
14 family-care homes, or other congregate residential facilities.
15 Section 109. Subsections (3) and subsection (6) of
16 section 400.93, Florida Statutes, are amended to read:
17 400.93 Licensure required; exemptions; unlawful acts;
18 penalties.--
19 (3) The requirements of part II of chapter 408 apply
20 to the provision of services that require licensure pursuant
21 to this part and part II of chapter 408 and to entities
22 licensed by or applying for such licensure from the agency
23 pursuant to this part. A license issued by the agency is
24 required in order to provide home medical equipment and
25 services in this state. A home medical equipment provider must
26 be licensed by the agency to operate in this state or to
27 provide home medical equipment and services to consumers in
28 this state. A standard license issued to a home medical
29 equipment provider, unless sooner suspended or revoked,
30 expires 2 years after its effective date.
31 (6)
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1 (a) It is unlawful for any person to offer or
2 advertise home medical equipment and services to the public
3 unless he or she has a valid license under this part or is
4 exempted from licensure under subsection (5). It is unlawful
5 for any holder of a license issued under this part to
6 advertise or indicate to the public that it holds a home
7 medical equipment provider license other than the one it has
8 been issued.
9 (a)(b) A person who violates paragraph (a) is subject
10 to an injunctive proceeding under s. 400.956. A violation of
11 s. 408.812 paragraph (a) is a deceptive and unfair trade
12 practice and constitutes a violation of the Florida Deceptive
13 and Unfair Trade Practices Act.
14 (b)(c) A person who violates s. 408.812 paragraph (a)
15 commits a misdemeanor of the second degree, punishable as
16 provided in s. 775.082 or s. 775.083. A person who commits a
17 second or subsequent violation commits a misdemeanor of the
18 first degree, punishable as provided in s. 775.082 or s.
19 775.083. Each day of continuing violation constitutes a
20 separate offense.
21 (d) The following penalties shall be imposed for
22 operating an unlicensed home medical equipment provider:
23 1. Any person or entity who operates an unlicensed
24 provider commits a felony of the third degree.
25 2. For any person or entity who has received
26 government reimbursement for services provided by an
27 unlicensed provider, the agency shall make a fraud referral to
28 the appropriate government reimbursement program.
29 3. For any licensee found to be concurrently operating
30 licensed and unlicensed provider premises, the agency may
31 impose a fine or moratorium, or revoke existing licenses of
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1 any or all of the licensee's licensed provider locations until
2 such time as the unlicensed provider premises is licensed.
3 (e) A provider found to be operating without a license
4 may apply for licensure, and must cease operations until a
5 license is awarded by the agency.
6 Section 110. Section 400.931, Florida Statutes, is
7 amended to read:
8 400.931 Application for license; fee; provisional
9 license; temporary permit.--
10 (1) Application for an initial license or for renewal
11 of an existing license must be made under oath to the agency
12 on forms furnished by it and must be accompanied by the
13 appropriate license fee as provided in subsection (12).
14 (1)(2) In addition to the requirements of part II of
15 chapter 408, the applicant must file with the application
16 satisfactory proof that the home medical equipment provider is
17 in compliance with this part and applicable rules, including:
18 (a) A report, by category, of the equipment to be
19 provided, indicating those offered either directly by the
20 applicant or through contractual arrangements with existing
21 providers. Categories of equipment include:
22 1. Respiratory modalities.
23 2. Ambulation aids.
24 3. Mobility aids.
25 4. Sickroom setup.
26 5. Disposables.
27 (b) A report, by category, of the services to be
28 provided, indicating those offered either directly by the
29 applicant or through contractual arrangements with existing
30 providers. Categories of services include:
31 1. Intake.
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1 2. Equipment selection.
2 3. Delivery.
3 4. Setup and installation.
4 5. Patient training.
5 6. Ongoing service and maintenance.
6 7. Retrieval.
7 (c) A listing of those with whom the applicant
8 contracts, both the providers the applicant uses to provide
9 equipment or services to its consumers and the providers for
10 whom the applicant provides services or equipment.
11 (2)(3) As an alternative to submitting proof of
12 financial ability to operate as required in s. 408.810(8) The
13 applicant for initial licensure must demonstrate financial
14 ability to operate, the applicant may submit which may be
15 accomplished by the submission of a $50,000 surety bond to the
16 agency.
17 (4) An applicant for renewal who has demonstrated
18 financial inability to operate must demonstrate financial
19 ability to operate.
20 (5) Each applicant for licensure must comply with the
21 following requirements:
22 (a) Upon receipt of a completed, signed, and dated
23 application, the agency shall require background screening of
24 the applicant, in accordance with the level 2 standards for
25 screening set forth in chapter 435. As used in this
26 subsection, the term "applicant" means the general manager and
27 the financial officer or similarly titled individual who is
28 responsible for the financial operation of the licensed
29 facility.
30 (b) The agency may require background screening for a
31 member of the board of directors of the licensee or an officer
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1 or an individual owning 5 percent or more of the licensee if
2 the agency has probable cause to believe that such individual
3 has been convicted of an offense prohibited under the level 2
4 standards for screening set forth in chapter 435.
5 (c) Proof of compliance with the level 2 background
6 screening requirements of chapter 435 which has been submitted
7 within the previous 5 years in compliance with any other
8 health care licensure requirements of this state is acceptable
9 in fulfillment of paragraph (a).
10 (d) Each applicant must submit to the agency, with its
11 application, a description and explanation of any exclusions,
12 permanent suspensions, or terminations of the applicant from
13 the Medicare or Medicaid programs. Proof of compliance with
14 disclosure of ownership and control interest requirements of
15 the Medicaid or Medicare programs shall be accepted in lieu of
16 this submission.
17 (e) Each applicant must submit to the agency a
18 description and explanation of any conviction of an offense
19 prohibited under the level 2 standards of chapter 435 by a
20 member of the board of directors of the applicant, its
21 officers, or any individual owning 5 percent or more of the
22 applicant. This requirement does not apply to a director of a
23 not-for-profit corporation or organization if the director
24 serves solely in a voluntary capacity for the corporation or
25 organization, does not regularly take part in the day-to-day
26 operational decisions of the corporation or organization,
27 receives no remuneration for his or her services on the
28 corporation's or organization's board of directors, and has no
29 financial interest and has no family members with a financial
30 interest in the corporation or organization, provided that the
31 director and the not-for-profit corporation or organization
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1 include in the application a statement affirming that the
2 director's relationship to the corporation satisfies the
3 requirements of this provision.
4 (f) A license may not be granted to any potential
5 licensee if any applicant, administrator, or financial officer
6 has been found guilty of, regardless of adjudication, or has
7 entered a plea of nolo contendere or guilty to, any offense
8 prohibited under the level 2 standards for screening set forth
9 in chapter 435, unless an exemption from disqualification has
10 been granted by the agency as set forth in chapter 435.
11 (g) The agency may deny or revoke licensure to any
12 potential licensee if any applicant:
13 1. Has falsely represented a material fact in the
14 application required by paragraphs (d) and (e), or has omitted
15 any material fact from the application required by paragraphs
16 (d) and (e); or
17 2. Has had prior Medicaid or Medicare action taken
18 against the applicant as set forth in paragraph (d).
19 (h) Upon licensure renewal, each applicant must submit
20 to the agency, under penalty of perjury, an affidavit of
21 compliance with the background screening provisions of this
22 section.
23 (3)(6) As specified in part II of chapter 408, the
24 home medical equipment provider must also obtain and maintain
25 professional and commercial liability insurance. Proof of
26 liability insurance, as defined in s. 624.605, must be
27 submitted with the application. The agency shall set the
28 required amounts of liability insurance by rule, but the
29 required amount must not be less than $250,000 per claim. In
30 the case of contracted services, it is required that the
31
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1 contractor have liability insurance not less than $250,000 per
2 claim.
3 (7) A provisional license shall be issued to an
4 approved applicant for initial licensure for a period of 90
5 days, during which time a survey must be conducted
6 demonstrating substantial compliance with this section. A
7 provisional license shall also be issued pending the results
8 of an applicant's Federal Bureau of Investigation report of
9 background screening confirming that all standards have been
10 met. If substantial compliance is demonstrated, a standard
11 license shall be issued to expire 2 years after the effective
12 date of the provisional license.
13 (8) Ninety days before the expiration date, an
14 application for license renewal must be submitted to the
15 agency under oath on forms furnished by the agency, and a
16 license shall be renewed if the applicant has met the
17 requirements established under this part and applicable rules.
18 The home medical equipment provider must file with the
19 application satisfactory proof that it is in compliance with
20 this part and applicable rules. The home medical equipment
21 provider must submit satisfactory proof of its financial
22 ability to comply with the requirements of this part.
23 (9) When a change of ownership of a home medical
24 equipment provider occurs, the prospective owner must submit
25 an initial application for a license at least 15 days before
26 the effective date of the change of ownership. An application
27 for change of ownership of a license is required when
28 ownership, a majority of the ownership, or controlling
29 interest of a licensed home medical equipment provider is
30 transferred or assigned and when a licensee agrees to
31 undertake or provide services to the extent that legal
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1 liability for operation of the home medical equipment provider
2 rests with the licensee. A provisional license shall be issued
3 to the new owner for a period of 90 days, during which time
4 all required documentation must be submitted and a survey must
5 be conducted demonstrating substantial compliance with this
6 section. If substantial compliance is demonstrated, a standard
7 license shall be issued to expire 2 years after the issuance
8 of the provisional license.
9 (4)(10) When a change of the general manager of a home
10 medical equipment provider occurs, the licensee must notify
11 the agency of the change within 45 days. thereof and must
12 provide evidence of compliance with the background screening
13 requirements in subsection (5); except that a general manager
14 who has met the standards for the Department of Law
15 Enforcement background check, but for whom background
16 screening results from the Federal Bureau of Investigation
17 have not yet been received, may be employed pending receipt of
18 the Federal Bureau of Investigation background screening
19 report. An individual may not continue to serve as general
20 manager if the Federal Bureau of Investigation background
21 screening report indicates any violation of background
22 screening standards.
23 (5)(11) In accordance with s. 408.805, an applicant or
24 a licensee shall pay a fee for each license application
25 submitted under this part, part II of chapter 408, and
26 applicable rules. The amount of the fee shall be established
27 by rule and may not exceed $300 per biennium. All licensure
28 fees required of a home medical equipment provider are
29 nonrefundable. The agency shall set the fees in an amount that
30 is sufficient to cover its costs in carrying out its
31 responsibilities under this part. However, state, county, or
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1 municipal governments applying for licenses under this part
2 are exempt from the payment of license fees. All fees
3 collected under this part must be deposited in the Health Care
4 Trust Fund for the administration of this part.
5 (6)(12) An applicant for initial licensure, renewal,
6 or change of ownership shall also pay a license processing fee
7 not to exceed $300, to be paid by all applicants, and an
8 inspection fee not to exceed $400, which shall to be paid by
9 all applicants except those not subject to licensure
10 inspection by the agency as described in s. 400.933(2).
11 (13) When a change is reported which requires issuance
12 of a license, a fee must be assessed. The fee must be based on
13 the actual cost of processing and issuing the license.
14 (14) When a duplicate license is issued, a fee must be
15 assessed, not to exceed the actual cost of duplicating and
16 mailing.
17 (15) When applications are mailed out upon request, a
18 fee must be assessed, not to exceed the cost of the printing,
19 preparation, and mailing.
20 (16) The license must be displayed in a conspicuous
21 place in the administrative office of the home medical
22 equipment provider and is valid only while in the possession
23 of the person or entity to which it is issued. The license may
24 not be sold, assigned, or otherwise transferred, voluntarily
25 or involuntarily, and is valid only for the home medical
26 equipment provider and location for which originally issued.
27 (17) A home medical equipment provider against whom a
28 proceeding for revocation or suspension, or for denial of a
29 renewal application, is pending at the time of license renewal
30 may be issued a provisional license effective until final
31 disposition by the agency of such proceedings. If judicial
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1 relief is sought from the final disposition, the court that
2 has jurisdiction may issue a temporary permit for the duration
3 of the judicial proceeding.
4 Section 111. Section 400.932, Florida Statutes, is
5 amended to read:
6 400.932 Administrative penalties; injunctions;
7 emergency orders; moratoriums.--
8 (1) The agency may deny, revoke, and or suspend a
9 license and, or impose an administrative fine not to exceed
10 $5,000 per violation, per day, or initiate injunctive
11 proceedings under s. 400.956.
12 (2) Any of the following actions by an employee of a
13 home medical equipment provider are or any of its employees is
14 grounds for administrative action or penalties by the agency:
15 (a) Violation of this part, part II of chapter 408, or
16 of applicable rules.
17 (b) An intentional, reckless, or negligent act that
18 materially affects the health or safety of a patient.
19 (3) The agency may deny or revoke the license of any
20 applicant that:
21 (a) Made a false representation or omission of any
22 material fact in making the application, including the
23 submission of an application that conceals the controlling or
24 ownership interest or any officer, director, agent, managing
25 employee, affiliated person, partner, or shareholder who may
26 not be eligible to participate;
27 (a)(b) Has been previously found by any professional
28 licensing, certifying, or standards board or agency to have
29 violated the standards or conditions relating to licensure or
30 certification or the quality of services provided.
31 "Professional licensing, certifying, or standards board or
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1 agency" shall include, but is not limited to, practitioners,
2 health care facilities, programs, or services, or residential
3 care, treatment programs, or other human services; or
4 (b)(c) Has been or is currently excluded, suspended,
5 or terminated from, or has involuntarily withdrawn from,
6 participation in Florida's Medicaid program or any other
7 state's Medicaid program, or participation in the Medicare
8 program or any other governmental or private health care or
9 health insurance program.
10 (4) The agency may issue an emergency order
11 immediately suspending or revoking a license when it
12 determines that any condition within the responsibility of the
13 home medical equipment provider presents a clear and present
14 danger to public health and safety.
15 (5) The agency may impose an immediate moratorium on
16 any licensed home medical equipment provider when the agency
17 determines that any condition within the responsibility of the
18 home medical equipment provider presents a threat to public
19 health or safety.
20 Section 112. Section 400.933, Florida Statutes, is
21 amended to read:
22 400.933 Licensure inspections and investigations.--
23 (1) In addition to the requirements of s. 408.811, the
24 agency shall make or cause to be made such inspections and
25 investigations as it considers necessary, including:
26 (a) Licensure inspections.
27 (b) Inspections directed by the federal Centers for
28 Medicare and Medicaid Services Health Care Financing
29 Administration.
30 (c) Licensure complaint investigations, including full
31 licensure investigations with a review of all licensure
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1 standards as outlined in the administrative rules. Complaints
2 received by the agency from individuals, organizations, or
3 other sources are subject to review and investigation by the
4 agency.
5 (2) The agency shall accept, in lieu of its own
6 periodic inspections for licensure, submission of the
7 following:
8 (a) The survey or inspection of an accrediting
9 organization, provided the accreditation of the licensed home
10 medical equipment provider is not provisional and provided the
11 licensed home medical equipment provider authorizes release
12 of, and the agency receives the report of, the accrediting
13 organization; or
14 (b) A copy of a valid medical oxygen retail
15 establishment permit issued by the Department of Health,
16 pursuant to chapter 499.
17 Section 113. Section 400.935, Florida Statutes, is
18 amended to read:
19 400.935 Rules establishing minimum standards.--The
20 agency shall adopt, publish, and enforce rules to implement
21 this part and part II of chapter 408, which must provide
22 reasonable and fair minimum standards relating to:
23 (1) The qualifications and minimum training
24 requirements of all home medical equipment provider personnel.
25 (2) License application and renewal.
26 (3) License and inspection fees.
27 (2)(4) Financial ability to operate.
28 (3)(5) The administration of the home medical
29 equipment provider.
30 (4)(6) Procedures for maintaining patient records.
31
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1 (5)(7) Ensuring that the home medical equipment and
2 services provided by a home medical equipment provider are in
3 accordance with the plan of treatment established for each
4 patient, when provided as a part of a plan of treatment.
5 (6)(8) Contractual arrangements for the provision of
6 home medical equipment and services by providers not employed
7 by the home medical equipment provider providing for the
8 consumer's needs.
9 (7)(9) Physical location and zoning requirements.
10 (8)(10) Home medical equipment requiring home medical
11 equipment services.
12 (9)(11) Preparation of the comprehensive emergency
13 management plan under s. 400.934 and the establishment of
14 minimum criteria for the plan, including the maintenance of
15 patient equipment and supply lists that can accompany patients
16 who are transported from their homes. Such rules shall be
17 formulated in consultation with the Department of Health and
18 the Department of Community Affairs.
19 Section 114. Section 400.95, Florida Statutes, is
20 repealed.
21 Section 115. Subsections (3) through (7) of section
22 400.953, Florida Statutes, are renumbered as subsections (2)
23 through (6), respectively, and present subsection (2) of that
24 section is amended to read:
25 400.953 Background screening of home medical equipment
26 provider personnel.--The agency shall require employment
27 screening as provided in chapter 435, using the level 1
28 standards for screening set forth in that chapter, for home
29 medical equipment provider personnel.
30 (2) The general manager of each home medical equipment
31 provider must sign an affidavit annually, under penalty of
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1 perjury, stating that all home medical equipment provider
2 personnel hired on or after July 1, 1999, who enter the home
3 of a patient in the capacity of their employment have been
4 screened and that its remaining personnel have worked for the
5 home medical equipment provider continuously since before July
6 1, 1999.
7 Section 116. Subsection (4) of section 400.955,
8 Florida Statutes, is amended to read:
9 400.955 Procedures for screening of home medical
10 equipment provider personnel.--
11 (4) The general manager of each home medical equipment
12 provider must sign an affidavit annually, under penalty of
13 perjury, stating that all personnel hired on or after July 1,
14 1999, have been screened and that its remaining personnel have
15 worked for the home medical equipment provider continuously
16 since before July 1, 1999.
17 Section 117. Section 400.956, Florida Statutes, is
18 repealed.
19 Section 118. Section 400.962, Florida Statutes, is
20 amended to read:
21 400.962 License required; license application.--
22 (1) The requirements of part II of chapter 408 apply
23 to the provision of services that require licensure pursuant
24 to this part and part II of chapter 408 and to entities
25 licensed by or applying for such licensure from the Agency for
26 Health Care Administration pursuant to this part. A license
27 issued by the agency is required in order to operate It is
28 unlawful to operate an intermediate care facility for the
29 developmentally disabled in this state without a license.
30 (2) Separate licenses are required for facilities
31 maintained on separate premises even if operated under the
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1 same management. However, a separate license is not required
2 for separate buildings on the same grounds.
3 (3) In accordance with s. 408.805, an applicant or
4 licensee shall pay a fee for each license application
5 submitted under this part, part II of chapter 408, and
6 applicable rules. The amount of the fee shall be $234 per bed
7 unless modified by rule. The basic license fee collected shall
8 be deposited in the Health Care Trust Fund, established for
9 carrying out the purposes of this chapter.
10 (4) The license must be conspicuously displayed inside
11 the facility.
12 (5) A license is valid only in the hands of the
13 individual, firm, partnership, association, or corporation to
14 whom it is issued. A license is not valid for any premises
15 other than those for which it was originally issued and may
16 not be sold, assigned, or otherwise transferred, voluntarily
17 or involuntarily.
18 (6) An application for a license shall be made to the
19 agency on forms furnished by it and must be accompanied by the
20 appropriate license fee.
21 (7) The application must be under oath and must
22 contain the following:
23 (a) The name, address, and social security number of
24 the applicant if an individual; if the applicant is a firm,
25 partnership, or association, its name, address, and employer
26 identification number (EIN), and the name and address of every
27 member; if the applicant is a corporation, its name, address,
28 and employer identification number (EIN), and the name and
29 address of its director and officers and of each person having
30 at least a 5 percent interest in the corporation; and the name
31 by which the facility is to be known.
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1 (b) The name of any person whose name is required on
2 the application under paragraph (a) and who owns at least a 10
3 percent interest in any professional service, firm,
4 association, partnership, or corporation providing goods,
5 leases, or services to the facility for which the application
6 is made, and the name and address of the professional service,
7 firm, association, partnership, or corporation in which such
8 interest is held.
9 (c) The application must indicate the location of the
10 facility for which a license is sought and an indication that
11 such location conforms to the local zoning ordinances.
12 (d) The name of the persons under whose management or
13 supervision the facility will be operated.
14 (e) The total number of beds.
15 (4)(8) The applicant must demonstrate that sufficient
16 numbers of staff, qualified by training or experience, will be
17 employed to properly care for the type and number of residents
18 who will reside in the facility.
19 (9) The applicant must submit evidence that
20 establishes the good moral character of the applicant,
21 manager, supervisor, and administrator. An applicant who is an
22 individual or a member of a board of directors or officer of
23 an applicant that is a firm, partnership, association, or
24 corporation must not have been convicted, or found guilty,
25 regardless of adjudication, of a crime in any jurisdiction
26 which affects or may potentially affect residents in the
27 facility.
28 (10)(a) Upon receipt of a completed, signed, and dated
29 application, the agency shall require background screening of
30 the applicant, in accordance with the level 2 standards for
31 screening set forth in chapter 435. As used in this
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1 subsection, the term "applicant" means the facility
2 administrator, or similarly titled individual who is
3 responsible for the day-to-day operation of the licensed
4 facility, and the facility financial officer, or similarly
5 titled individual who is responsible for the financial
6 operation of the licensed facility.
7 (b) The agency may require background screening for a
8 member of the board of directors of the licensee or an officer
9 or an individual owning 5 percent or more of the licensee if
10 the agency has probable cause to believe that such individual
11 has been convicted of an offense prohibited under the level 2
12 standards for screening set forth in chapter 435.
13 (c) Proof of compliance with the level 2 background
14 screening requirements of chapter 435 which has been submitted
15 within the previous 5 years in compliance with any other
16 licensure requirements under this chapter or chapter 429
17 satisfies the requirements of paragraph (a). Proof of
18 compliance with background screening which has been submitted
19 within the previous 5 years to fulfill the requirements of the
20 Financial Services Commission and the Office of Insurance
21 Regulation under chapter 651 as part of an application for a
22 certificate of authority to operate a continuing care
23 retirement community satisfies the requirements for the
24 Department of Law Enforcement and Federal Bureau of
25 Investigation background checks.
26 (d) A provisional license may be granted to an
27 applicant when each individual required by this section to
28 undergo background screening has met the standards for the
29 Department of Law Enforcement background check, but the agency
30 has not yet received background screening results from the
31 Federal Bureau of Investigation, or a request for a
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1 disqualification exemption has been submitted to the agency as
2 set forth in chapter 435, but a response has not yet been
3 issued. A license may be granted to the applicant upon the
4 agency's receipt of a report of the results of the Federal
5 Bureau of Investigation background screening for each
6 individual required by this section to undergo background
7 screening which confirms that all standards have been met, or
8 upon the granting of a disqualification exemption by the
9 agency as set forth in chapter 435. Any other person who is
10 required to undergo level 2 background screening may serve in
11 his or her capacity pending the agency's receipt of the report
12 from the Federal Bureau of Investigation; however, the person
13 may not continue to serve if the report indicates any
14 violation of background screening standards and a
15 disqualification exemption has not been granted by the agency
16 as set forth in chapter 435.
17 (e) Each applicant must submit to the agency, with its
18 application, a description and explanation of any exclusions,
19 permanent suspensions, or terminations of the applicant from
20 the Medicare or Medicaid programs. Proof of compliance with
21 disclosure of ownership and control interest requirements of
22 the Medicaid or Medicare programs shall be accepted in lieu of
23 this submission.
24 (f) Each applicant must submit to the agency a
25 description and explanation of any conviction of an offense
26 prohibited under the level 2 standards of chapter 435 by a
27 member of the board of directors of the applicant, its
28 officers, or any individual owning 5 percent or more of the
29 applicant. This requirement does not apply to a director of a
30 not-for-profit corporation or organization if the director
31 serves solely in a voluntary capacity for the corporation or
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1 organization, does not regularly take part in the day-to-day
2 operational decisions of the corporation or organization,
3 receives no remuneration for his or her services on the
4 corporation's or organization's board of directors, and has no
5 financial interest and has no family members with a financial
6 interest in the corporation or organization, provided that the
7 director and the not-for-profit corporation or organization
8 include in the application a statement affirming that the
9 director's relationship to the corporation satisfies the
10 requirements of this paragraph.
11 (g) An application for license renewal must contain
12 the information required under paragraphs (e) and (f).
13 (11) The applicant must furnish satisfactory proof of
14 financial ability to operate and conduct the facility in
15 accordance with the requirements of this part and all rules
16 adopted under this part, and the agency shall establish
17 standards for this purpose.
18 (5)(12) The applicant must agree to provide or arrange
19 for active treatment services by an interdisciplinary team to
20 maximize individual independence or prevent regression or loss
21 of functional status. Standards for active treatment shall be
22 adopted by the Agency for Health Care Administration by rule
23 pursuant to ss. 120.536(1) and 120.54. Active treatment
24 services shall be provided in accordance with the individual
25 support plan and shall be reimbursed as part of the per diem
26 rate as paid under the Medicaid program.
27 Section 119. Section 400.963, Florida Statutes, is
28 repealed.
29 Section 120. Section 400.965, Florida Statutes, is
30 repealed.
31
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1 Section 121. Section 400.967, Florida Statutes, is
2 amended to read:
3 400.967 Rules and classification of deficiencies.--
4 (1) It is the intent of the Legislature that rules
5 adopted and enforced under this part and part II of chapter
6 408 include criteria by which a reasonable and consistent
7 quality of resident care may be ensured, the results of such
8 resident care can be demonstrated, and safe and sanitary
9 facilities can be provided.
10 (2) Pursuant to the intention of the Legislature, the
11 agency, in consultation with the Agency for Persons with
12 Disabilities and the Department of Elderly Affairs, shall
13 adopt and enforce rules to administer this part and part II of
14 chapter 408, which shall include reasonable and fair criteria
15 governing:
16 (a) The location and construction of the facility;
17 including fire and life safety, plumbing, heating, cooling,
18 lighting, ventilation, and other housing conditions that will
19 ensure the health, safety, and comfort of residents. The
20 agency shall establish standards for facilities and equipment
21 to increase the extent to which new facilities and a new wing
22 or floor added to an existing facility after July 1, 2000, are
23 structurally capable of serving as shelters only for
24 residents, staff, and families of residents and staff, and
25 equipped to be self-supporting during and immediately
26 following disasters. The Agency for Health Care Administration
27 shall work with facilities licensed under this part and report
28 to the Governor and the Legislature by April 1, 2000, its
29 recommendations for cost-effective renovation standards to be
30 applied to existing facilities. In making such rules, the
31 agency shall be guided by criteria recommended by nationally
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1 recognized, reputable professional groups and associations
2 having knowledge concerning such subject matters. The agency
3 shall update or revise such criteria as the need arises. All
4 facilities must comply with those lifesafety code requirements
5 and building code standards applicable at the time of approval
6 of their construction plans. The agency may require
7 alterations to a building if it determines that an existing
8 condition constitutes a distinct hazard to life, health, or
9 safety. The agency shall adopt fair and reasonable rules
10 setting forth conditions under which existing facilities
11 undergoing additions, alterations, conversions, renovations,
12 or repairs are required to comply with the most recent updated
13 or revised standards.
14 (b) The number and qualifications of all personnel,
15 including management, medical nursing, and other personnel,
16 having responsibility for any part of the care given to
17 residents.
18 (c) All sanitary conditions within the facility and
19 its surroundings, including water supply, sewage disposal,
20 food handling, and general hygiene, which will ensure the
21 health and comfort of residents.
22 (d) The equipment essential to the health and welfare
23 of the residents.
24 (e) A uniform accounting system.
25 (f) The care, treatment, and maintenance of residents
26 and measurement of the quality and adequacy thereof.
27 (g) The preparation and annual update of a
28 comprehensive emergency management plan. The agency shall
29 adopt rules establishing minimum criteria for the plan after
30 consultation with the Department of Community Affairs. At a
31 minimum, the rules must provide for plan components that
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1 address emergency evacuation transportation; adequate
2 sheltering arrangements; postdisaster activities, including
3 emergency power, food, and water; postdisaster transportation;
4 supplies; staffing; emergency equipment; individual
5 identification of residents and transfer of records; and
6 responding to family inquiries. The comprehensive emergency
7 management plan is subject to review and approval by the local
8 emergency management agency. During its review, the local
9 emergency management agency shall ensure that the following
10 agencies, at a minimum, are given the opportunity to review
11 the plan: the Department of Elderly Affairs, the Agency for
12 Persons with Disabilities, the Agency for Health Care
13 Administration, and the Department of Community Affairs. Also,
14 appropriate volunteer organizations must be given the
15 opportunity to review the plan. The local emergency management
16 agency shall complete its review within 60 days and either
17 approve the plan or advise the facility of necessary
18 revisions.
19 (h) The posting of licenses. Each licensee shall post
20 its license in a prominent place that is in clear and
21 unobstructed public view at or near the place where residents
22 are being admitted to the facility.
23 (h)(i) The use of restraint and seclusion. Such rules
24 must be consistent with recognized best practices; prohibit
25 inherently dangerous restraint or seclusion procedures;
26 establish limitations on the use and duration of restraint and
27 seclusion; establish measures to ensure the safety of clients
28 and staff during an incident of restraint or seclusion;
29 establish procedures for staff to follow before, during, and
30 after incidents of restraint or seclusion, including
31 individualized plans for the use of restraints or seclusion in
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1 emergency situations; establish professional qualifications of
2 and training for staff who may order or be engaged in the use
3 of restraint or seclusion; establish requirements for facility
4 data collection and reporting relating to the use of restraint
5 and seclusion; and establish procedures relating to the
6 documentation of the use of restraint or seclusion in the
7 client's facility or program record.
8 (3) The agency shall adopt rules to provide that, when
9 the criteria established under this part and part II of
10 chapter 408 subsection (2) are not met, such deficiencies
11 shall be classified according to the nature of the deficiency.
12 The agency shall indicate the classification on the face of
13 the notice of deficiencies as follows:
14 (a) Class I deficiencies are those which the agency
15 determines present an and imminent danger to the residents or
16 guests of the facility or a substantial probability that death
17 or serious physical harm would result therefrom. The condition
18 or practice constituting a class I violation must be abated or
19 eliminated immediately, unless a fixed period of time, as
20 determined by the agency, is required for correction.
21 Notwithstanding s. 400.121(2), A class I deficiency is subject
22 to a civil penalty in an amount not less than $5,000 and not
23 exceeding $10,000 for each deficiency. A fine may be levied
24 notwithstanding the correction of the deficiency.
25 (b) Class II deficiencies are those which the agency
26 determines have a direct or immediate relationship to the
27 health, safety, or security of the facility residents, other
28 than class I deficiencies. A class II deficiency is subject to
29 a civil penalty in an amount not less than $1,000 and not
30 exceeding $5,000 for each deficiency. A citation for a class
31 II deficiency shall specify the time within which the
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1 deficiency must be corrected. If a class II deficiency is
2 corrected within the time specified, no civil penalty shall be
3 imposed, unless it is a repeated offense.
4 (c) Class III deficiencies are those which the agency
5 determines to have an indirect or potential relationship to
6 the health, safety, or security of the facility residents,
7 other than class I or class II deficiencies. A class III
8 deficiency is subject to a civil penalty of not less than $500
9 and not exceeding $1,000 for each deficiency. A citation for a
10 class III deficiency shall specify the time within which the
11 deficiency must be corrected. If a class III deficiency is
12 corrected within the time specified, no civil penalty shall be
13 imposed, unless it is a repeated offense.
14 (4) Civil penalties paid by any licensee under
15 subsection (3) shall be deposited in the Health Care Trust
16 Fund and expended as provided in s. 400.063.
17 (4)(5) The agency shall approve or disapprove the
18 plans and specifications within 60 days after receipt of the
19 final plans and specifications. The agency may be granted one
20 15-day extension for the review period, if the secretary of
21 the agency so approves. If the agency fails to act within the
22 specified time, it is deemed to have approved the plans and
23 specifications. When the agency disapproves plans and
24 specifications, it must set forth in writing the reasons for
25 disapproval. Conferences and consultations may be provided as
26 necessary.
27 (5)(6) The agency may charge an initial fee of $2,000
28 for review of plans and construction on all projects, no part
29 of which is refundable. The agency may also collect a fee, not
30 to exceed 1 percent of the estimated construction cost or the
31 actual cost of review, whichever is less, for the portion of
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1 the review which encompasses initial review through the
2 initial revised construction document review. The agency may
3 collect its actual costs on all subsequent portions of the
4 review and construction inspections. Initial fee payment must
5 accompany the initial submission of plans and specifications.
6 Any subsequent payment that is due is payable upon receipt of
7 the invoice from the agency. Notwithstanding any other
8 provision of law, all money received by the agency under this
9 section shall be deemed to be trust funds, to be held and
10 applied solely for the operations required under this section.
11 Section 122. Section 400.968, Florida Statutes, is
12 amended to read:
13 400.968 Right of entry; protection of health, safety,
14 and welfare.--
15 (1) In addition to the requirements of s. 408.811, any
16 designated officer or employee of the agency, or any officer
17 or employee of the state, or of the local fire marshal, may
18 enter unannounced the premises of any facility licensed under
19 this part in order to determine the state of compliance with
20 this part, part II of chapter 408, and applicable rules and
21 the rules or standards in force under this part. The right of
22 entry and inspection also extends to any premises that the
23 agency has reason to believe are being operated or maintained
24 as a facility without a license; but such an entry or
25 inspection may not be made without the permission of the owner
26 or person in charge of the facility unless a warrant that
27 authorizes the entry is first obtained from the circuit court.
28 The warrant requirement extends only to a facility that the
29 agency has reason to believe is being operated or maintained
30 as a facility without a license. An application for a license
31 or renewal thereof which is made under this section
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1 constitutes permission for, and acquiescence in, any entry or
2 inspection of the premises for which the license is sought, in
3 order to facilitate verification of the information submitted
4 in connection with the application; to discover, investigate,
5 and determine the existence of abuse or neglect; or to elicit,
6 receive, respond to, and resolve complaints. A current valid
7 license constitutes unconditional permission for, and
8 acquiescence in, any entry or inspection of the premises by
9 authorized personnel. The agency retains the right of entry
10 and inspection of facilities that have had a license revoked
11 or suspended within the previous 24 months, to ensure that the
12 facility is not operating unlawfully. However, before the
13 facility is entered, a statement of probable cause must be
14 filed with the director of the agency, who must approve or
15 disapprove the action within 48 hours.
16 (2) The agency may institute injunctive proceedings in
17 a court of competent jurisdiction for temporary or permanent
18 relief to:
19 (a) Enforce this section or any minimum standard,
20 rule, or order issued pursuant thereto if the agency's effort
21 to correct a violation through administrative fines has failed
22 or when the violation materially affects the health, safety,
23 or welfare of residents; or
24 (b) Terminate the operation of a facility if a
25 violation of this section or of any standard or rule adopted
26 pursuant thereto exists which materially affects the health,
27 safety, or welfare of residents.
28
29 The Legislature recognizes that, in some instances, action is
30 necessary to protect residents of facilities from immediately
31 life-threatening situations. If it appears by competent
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1 evidence or a sworn, substantiated affidavit that a temporary
2 injunction should issue, the court, pending the determination
3 on final hearing, shall enjoin operation of the facility.
4 (3) The agency may impose an immediate moratorium on
5 admissions to a facility when the agency determines that any
6 condition in the facility presents a threat to the health,
7 safety, or welfare of the residents in the facility. If a
8 facility's license is denied, revoked, or suspended, the
9 facility may be subject to the immediate imposition of a
10 moratorium on admissions to run concurrently with licensure
11 denial, revocation, or suspension.
12 Section 123. Subsection (1) of section 400.969,
13 Florida Statutes, is amended to read:
14 400.969 Violation of part; penalties.--
15 (1) In addition to the requirements of part II of
16 chapter 408, and except as provided in s. 400.967(3), a
17 violation of any provision of this part, part II of chapter
18 408, or applicable rules adopted by the agency under this part
19 is punishable by payment of an administrative or civil penalty
20 not to exceed $5,000.
21 Section 124. Section 400.980, Florida Statutes, is
22 amended to read:
23 400.980 Health care services pools.--
24 (1) As used in this section, the term:
25 (a) "Agency" means the Agency for Health Care
26 Administration.
27 (b) "Health care services pool" means any person,
28 firm, corporation, partnership, or association engaged for
29 hire in the business of providing temporary employment in
30 health care facilities, residential facilities, and agencies
31 for licensed, certified, or trained health care personnel
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1 including, without limitation, nursing assistants, nurses'
2 aides, and orderlies. However, the term does not include
3 nursing registries, a facility licensed under this chapter or
4 chapter 429, a health care services pool established within a
5 health care facility to provide services only within the
6 confines of such facility, or any individual contractor
7 directly providing temporary services to a health care
8 facility without use or benefit of a contracting agent.
9 (2) The requirements of part II of chapter 408 apply
10 to the provision of services that require licensure or
11 registration pursuant to this part and part II of chapter 408
12 and to entities registered by or applying for such
13 registration from the agency pursuant to this part.
14 Registration or a license issued by the agency is required for
15 the operation of Each person who operates a health care
16 services pool in this state. In accordance with s. 408.805, an
17 applicant or licensee shall pay a fee for each license
18 application submitted using this part, part II of chapter 408,
19 and applicable rules. must register each separate business
20 location with the agency. The agency shall adopt rules and
21 provide forms required for such registration and shall impose
22 a registration fee in an amount sufficient to cover the cost
23 of administering this part and part II of chapter 408 section.
24 In addition to the requirements in part II of chapter 408, the
25 registrant must provide the agency with any change of
26 information contained on the original registration application
27 within 14 days prior to the change. The agency may inspect the
28 offices of any health care services pool at any reasonable
29 time for the purpose of determining compliance with this
30 section or the rules adopted under this section.
31 (3) Each application for registration must include:
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1 (a) The name and address of any person who has an
2 ownership interest in the business, and, in the case of a
3 corporate owner, copies of the articles of incorporation,
4 bylaws, and names and addresses of all officers and directors
5 of the corporation.
6 (b) Any other information required by the agency.
7 (3)(4) Each applicant for registration must comply
8 with the following requirements:
9 (a) Upon receipt of a completed, signed, and dated
10 application, the agency shall require background screening, in
11 accordance with the level 1 standards for screening set forth
12 in chapter 435, of every individual who will have contact with
13 patients. The agency shall require background screening of the
14 managing employee or other similarly titled individual who is
15 responsible for the operation of the entity, and of the
16 financial officer or other similarly titled individual who is
17 responsible for the financial operation of the entity,
18 including billings for services in accordance with the level 2
19 standards for background screening as set forth in chapter
20 435.
21 (b) The agency may require background screening of any
22 other individual who is affiliated with the applicant if the
23 agency has a reasonable basis for believing that he or she has
24 been convicted of a crime or has committed any other offense
25 prohibited under the level 2 standards for screening set forth
26 in chapter 435.
27 (c) Proof of compliance with the level 2 background
28 screening requirements of chapter 435 which has been submitted
29 within the previous 5 years in compliance with any other
30 health care or assisted living licensure requirements of this
31 state is acceptable in fulfillment of paragraph (a).
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1 (d) A provisional registration may be granted to an
2 applicant when each individual required by this section to
3 undergo background screening has met the standards for the
4 Department of Law Enforcement background check but the agency
5 has not yet received background screening results from the
6 Federal Bureau of Investigation. A standard registration may
7 be granted to the applicant upon the agency's receipt of a
8 report of the results of the Federal Bureau of Investigation
9 background screening for each individual required by this
10 section to undergo background screening which confirms that
11 all standards have been met, or upon the granting of a
12 disqualification exemption by the agency as set forth in
13 chapter 435. Any other person who is required to undergo level
14 2 background screening may serve in his or her capacity
15 pending the agency's receipt of the report from the Federal
16 Bureau of Investigation. However, the person may not continue
17 to serve if the report indicates any violation of background
18 screening standards and if a disqualification exemption has
19 not been requested of and granted by the agency as set forth
20 in chapter 435.
21 (e) Each applicant must submit to the agency, with its
22 application, a description and explanation of any exclusions,
23 permanent suspensions, or terminations of the applicant from
24 the Medicare or Medicaid programs. Proof of compliance with
25 the requirements for disclosure of ownership and controlling
26 interests under the Medicaid or Medicare programs may be
27 accepted in lieu of this submission.
28 (f) Each applicant must submit to the agency a
29 description and explanation of any conviction of an offense
30 prohibited under the level 2 standards of chapter 435 which
31 was committed by a member of the board of directors of the
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1 applicant, its officers, or any individual owning 5 percent or
2 more of the applicant. This requirement does not apply to a
3 director of a not-for-profit corporation or organization who
4 serves solely in a voluntary capacity for the corporation or
5 organization, does not regularly take part in the day-to-day
6 operational decisions of the corporation or organization,
7 receives no remuneration for his or her services on the
8 corporation's or organization's board of directors, and has no
9 financial interest and no family members having a financial
10 interest in the corporation or organization, if the director
11 and the not-for-profit corporation or organization include in
12 the application a statement affirming that the director's
13 relationship to the corporation satisfies the requirements of
14 this paragraph.
15 (g) A registration may not be granted to an applicant
16 if the applicant or managing employee has been found guilty
17 of, regardless of adjudication, or has entered a plea of nolo
18 contendere or guilty to, any offense prohibited under the
19 level 2 standards for screening set forth in chapter 435,
20 unless an exemption from disqualification has been granted by
21 the agency as set forth in chapter 435.
22 (h) Failure to provide all required documentation
23 within 30 days after a written request from the agency will
24 result in denial of the application for registration.
25 (i) The agency must take final action on an
26 application for registration within 60 days after receipt of
27 all required documentation.
28 (j) The agency may deny, revoke, or suspend the
29 registration of any applicant or registrant who:
30 1. Has falsely represented a material fact in the
31 application required by paragraph (e) or paragraph (f), or has
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1 omitted any material fact from the application required by
2 paragraph (e) or paragraph (f); or
3 2. Has had prior action taken against the applicant
4 under the Medicaid or Medicare program as set forth in
5 paragraph (e).
6 3. Fails to comply with this section or applicable
7 rules.
8 4. Commits an intentional, reckless, or negligent act
9 that materially affects the health or safety of a person
10 receiving services.
11 (5) It is a misdemeanor of the first degree,
12 punishable under s. 775.082 or s. 775.083, for any person
13 willfully, knowingly, or intentionally to:
14 (a) Fail, by false statement, misrepresentation,
15 impersonation, or other fraudulent means, to disclose in any
16 application for voluntary or paid employment a material fact
17 used in making a determination as to an applicant's
18 qualifications to be a contractor under this section;
19 (b) Operate or attempt to operate an entity registered
20 under this part with persons who do not meet the minimum
21 standards of chapter 435 as contained in this section; or
22 (c) Use information from the criminal records obtained
23 under this section for any purpose other than screening an
24 applicant for temporary employment as specified in this
25 section, or release such information to any other person for
26 any purpose other than screening for employment under this
27 section.
28 (6) It is a felony of the third degree, punishable
29 under s. 775.082, s. 775.083, or s. 775.084, for any person
30 willfully, knowingly, or intentionally to use information from
31 the juvenile records of a person obtained under this section
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1 for any purpose other than screening for employment under this
2 section.
3 (7) It is unlawful for a person to offer or advertise
4 services, as defined by rule, to the public without obtaining
5 a certificate of registration from the Agency for Health Care
6 Administration. It is unlawful for any holder of a certificate
7 of registration to advertise or hold out to the public that he
8 or she holds a certificate of registration for other than that
9 for which he or she actually holds a certificate of
10 registration. Any person who violates this subsection is
11 subject to injunctive proceedings under s. 400.515.
12 (8) Each registration shall be for a period of 2
13 years. The application for renewal must be received by the
14 agency at least 30 days before the expiration date of the
15 registration. An application for a new registration is
16 required within 30 days prior to the sale of a controlling
17 interest in a health care services pool.
18 (4)(9) A health care services pool may not require an
19 employee to recruit new employees from persons employed at a
20 health care facility to which the health care services pool
21 employee is assigned. Nor shall a health care facility to
22 which employees of a health care services pool are assigned
23 recruit new employees from the health care services pool.
24 (5)(10) A health care services pool shall document
25 that each temporary employee provided to a health care
26 facility has met the licensing, certification, training, or
27 continuing education requirements, as established by the
28 appropriate regulatory agency, for the position in which he or
29 she will be working.
30 (6)(11) When referring persons for temporary
31 employment in health care facilities, a health care services
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1 pool shall comply with all pertinent state and federal laws,
2 rules, and regulations relating to health, background
3 screening, and other qualifications required of persons
4 working in a facility of that type.
5 (7)(12)(a) As a condition of registration and prior to
6 the issuance or renewal of a certificate of registration, a
7 health care services pool applicant must prove financial
8 responsibility to pay claims, and costs ancillary thereto,
9 arising out of the rendering of services or failure to render
10 services by the pool or by its employees in the course of
11 their employment with the pool. The agency shall promulgate
12 rules establishing minimum financial responsibility coverage
13 amounts which shall be adequate to pay potential claims and
14 costs ancillary thereto.
15 (b) Each health care services pool shall give written
16 notification to the agency within 20 days after any change in
17 the method of assuring financial responsibility or upon
18 cancellation or nonrenewal of professional liability
19 insurance. Unless the pool demonstrates that it is otherwise
20 in compliance with the requirements of this subsection
21 section, the agency shall suspend the registration of the pool
22 pursuant to s. 408.814 ss. 120.569 and 120.57. Any suspension
23 under this section shall remain in effect until the pool
24 demonstrates compliance with the requirements of this
25 subsection section.
26 (c) Proof of financial responsibility must be
27 demonstrated to the satisfaction of the agency, through one of
28 the following methods:
29 1. Establishing and maintaining an escrow account
30 consisting of cash or assets eligible for deposit in
31 accordance with s. 625.52;
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1 2. Obtaining and maintaining an unexpired irrevocable
2 letter of credit established pursuant to chapter 675. Such
3 letters of credit shall be nontransferable and nonassignable
4 and shall be issued by any bank or savings association
5 organized and existing under the laws of this state or any
6 bank or savings association organized under the laws of the
7 United States that has its principal place of business in this
8 state or has a branch office which is authorized under the
9 laws of this state or of the United States to receive deposits
10 in this state; or
11 3. Obtaining and maintaining professional liability
12 coverage from one of the following:
13 a. An authorized insurer as defined under s. 624.09;
14 b. An eligible surplus lines insurer as defined under
15 s. 626.918(2);
16 c. A risk retention group or purchasing group as
17 defined under s. 627.942; or
18 d. A plan of self-insurance as provided in s. 627.357.
19 (d) If financial responsibility requirements are met
20 by maintaining an escrow account or letter of credit, as
21 provided in this subsection section, upon the entry of an
22 adverse final judgment arising from a medical malpractice
23 arbitration award from a claim of medical malpractice either
24 in contract or tort, or from noncompliance with the terms of a
25 settlement agreement arising from a claim of medical
26 malpractice either in contract or tort, the financial
27 institution holding the escrow account or the letter of credit
28 shall pay directly to the claimant the entire amount of the
29 judgment together with all accrued interest or the amount
30 maintained in the escrow account or letter of credit as
31 required by this subsection section, whichever is less, within
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1 60 days after the date such judgment became final and subject
2 to execution, unless otherwise mutually agreed to in writing
3 by the parties. If timely payment is not made, the agency
4 shall suspend the registration of the pool pursuant to
5 procedures set forth by the agency through rule. Nothing in
6 this paragraph shall abrogate a judgment debtor's obligation
7 to satisfy the entire amount of any judgment.
8 (e) Each health care services pool carrying
9 claims-made coverage must demonstrate proof of extended
10 reporting coverage through either tail or nose coverage, in
11 the event the policy is canceled, replaced, or not renewed.
12 Such extended coverage shall provide coverage for incidents
13 that occurred during the claims-made policy period but were
14 reported after the policy period.
15 (f) The financial responsibility requirements of this
16 subsection section shall apply to claims for incidents that
17 occur on or after January 1, 1991, or the initial date of
18 registration in this state, whichever is later.
19 (g) Meeting the financial responsibility requirements
20 of this subsection section must be established at the time of
21 issuance or renewal of a certificate of registration.
22 (8)(13) In addition to the requirements of part II of
23 chapter 408, the agency shall adopt rules to implement this
24 part section, including rules providing for the establishment
25 of:
26 (a) Minimum standards for the operation and
27 administration of health care personnel pools, including
28 procedures for recordkeeping and personnel.
29 (b) Fines for the violation of this part, part II of
30 chapter 408, or applicable rules section in an amount not to
31 exceed $2,500 and suspension or revocation of registration.
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1 (c) Disciplinary sanctions for failure to comply with
2 this section or the rules adopted under this section.
3 Section 125. Section 400.991, Florida Statutes, is
4 amended to read:
5 400.991 License requirements; background screenings;
6 prohibitions.--
7 (1)(a) The requirements of part II of chapter 408
8 apply to the provision of services that require licensure
9 pursuant to this part and part II of chapter 408 and to
10 entities licensed by or applying for such licensure from the
11 agency pursuant to this part. A license issued by the agency
12 is required in order to operate a clinic in this state. Each
13 clinic, as defined in s. 400.9905, must be licensed and shall
14 at all times maintain a valid license with the agency. Each
15 clinic location shall be licensed separately regardless of
16 whether the clinic is operated under the same business name or
17 management as another clinic.
18 (b) Each mobile clinic must obtain a separate health
19 care clinic license and must provide to the agency, at least
20 quarterly, its projected street location to enable the agency
21 to locate and inspect such clinic. A portable equipment
22 provider must obtain a health care clinic license for a single
23 administrative office and is not required to submit quarterly
24 projected street locations.
25 (2) The initial clinic license application shall be
26 filed with the agency by all clinics, as defined in s.
27 400.9905, on or before July 1, 2004. A clinic license must be
28 renewed biennially.
29 (3) Applicants that submit an application on or before
30 July 1, 2004, which meets all requirements for initial
31 licensure as specified in this section shall receive a
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1 temporary license until the completion of an initial
2 inspection verifying that the applicant meets all requirements
3 in rules authorized in s. 400.9925. However, a clinic engaged
4 in magnetic resonance imaging services may not receive a
5 temporary license unless it presents evidence satisfactory to
6 the agency that such clinic is making a good faith effort and
7 substantial progress in seeking accreditation required under
8 s. 400.9935.
9 (4) Application for an initial clinic license or for
10 renewal of an existing license shall be notarized on forms
11 furnished by the agency and must be accompanied by the
12 appropriate license fee as provided in s. 400.9925. The agency
13 shall take final action on an initial license application
14 within 60 days after receipt of all required documentation.
15 (3)(5) The application shall contain information that
16 includes, but need not be limited to, information pertaining
17 to the name, residence and business address, phone number,
18 social security number, and license number of the medical or
19 clinic director, of the licensed medical providers employed or
20 under contract with the clinic, and of each person who,
21 directly or indirectly, owns or controls 5 percent or more of
22 an interest in the clinic, or general partners in limited
23 liability partnerships.
24 (4)(6) In addition to the requirements of part II of
25 chapter 408, the applicant must file with the application
26 satisfactory proof that the clinic is in compliance with this
27 part and applicable rules, including:
28 (a) A listing of services to be provided either
29 directly by the applicant or through contractual arrangements
30 with existing providers;
31
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1 (b) The number and discipline of each professional
2 staff member to be employed; and
3 (c) Proof of financial ability to operate as required
4 under s. 408.810(8). An applicant must demonstrate financial
5 ability to operate a clinic by submitting a balance sheet and
6 an income and expense statement for the first year of
7 operation which provide evidence of the applicant's having
8 sufficient assets, credit, and projected revenues to cover
9 liabilities and expenses. The applicant shall have
10 demonstrated financial ability to operate if the applicant's
11 assets, credit, and projected revenues meet or exceed
12 projected liabilities and expenses. All documents required
13 under this subsection must be prepared in accordance with
14 generally accepted accounting principles, may be in a
15 compilation form, and the financial statement must be signed
16 by a certified public accountant. As an alternative to
17 submitting proof of financial ability to operate as required
18 under s. 408.810(8) a balance sheet and an income and expense
19 statement for the first year of operation, the applicant may
20 file a surety bond of at least $500,000 which guarantees that
21 the clinic will act in full conformity with all legal
22 requirements for operating a clinic, payable to the agency.
23 The agency may adopt rules to specify related requirements for
24 such surety bond.
25 (5)(7) Each applicant for licensure shall comply with
26 the following requirements:
27 (a) As used in this subsection, the term "applicant"
28 means individuals owning or controlling, directly or
29 indirectly, 5 percent or more of an interest in a clinic; the
30 medical or clinic director, or a similarly titled person who
31 is responsible for the day-to-day operation of the licensed
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1 clinic; the financial officer or similarly titled individual
2 who is responsible for the financial operation of the clinic;
3 and licensed health care practitioners at the clinic.
4 (b) Upon receipt of a completed, signed, and dated
5 application, the agency shall require background screening of
6 the applicant, in accordance with the level 2 standards for
7 screening set forth in chapter 435. Proof of compliance with
8 the level 2 background screening requirements of chapter 435
9 which has been submitted within the previous 5 years in
10 compliance with any other health care licensure requirements
11 of this state is acceptable in fulfillment of this paragraph.
12 Applicants who own less than 10 percent of a health care
13 clinic are not required to submit fingerprints under this
14 section.
15 (c) Each applicant must submit to the agency, with the
16 application, a description and explanation of any exclusions,
17 permanent suspensions, or terminations of an applicant from
18 the Medicare or Medicaid programs. Proof of compliance with
19 the requirements for disclosure of ownership and control
20 interest under the Medicaid or Medicare programs may be
21 accepted in lieu of this submission. The description and
22 explanation may indicate whether such exclusions, suspensions,
23 or terminations were voluntary or not voluntary on the part of
24 the applicant.
25 (d) A license may not be granted to a clinic if the
26 applicant has been found guilty of, regardless of
27 adjudication, or has entered a plea of nolo contendere or
28 guilty to, any offense prohibited under the level 2 standards
29 for screening set forth in chapter 435, or a violation of
30 insurance fraud under s. 817.234, within the past 5 years. If
31 the applicant has been convicted of an offense prohibited
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1 under the level 2 standards or insurance fraud in any
2 jurisdiction, the applicant must show that his or her civil
3 rights have been restored prior to submitting an application.
4 (e) The agency may deny or revoke licensure if the
5 applicant has falsely represented any material fact or omitted
6 any material fact from the application required by this part.
7 (8) Requested information omitted from an application
8 for licensure, license renewal, or transfer of ownership must
9 be filed with the agency within 21 days after receipt of the
10 agency's request for omitted information, or the application
11 shall be deemed incomplete and shall be withdrawn from further
12 consideration.
13 (9) The failure to file a timely renewal application
14 shall result in a late fee charged to the facility in an
15 amount equal to 50 percent of the current license fee.
16 Section 126. Section 400.9915, Florida Statutes, is
17 amended to read:
18 400.9915 Clinic inspections; Emergency suspension;
19 costs.--
20 (1) Any authorized officer or employee of the agency
21 shall make inspections of the clinic as part of the initial
22 license application or renewal application. The application
23 for a clinic license issued under this part or for a renewal
24 license constitutes permission for an appropriate agency
25 inspection to verify the information submitted on or in
26 connection with the application or renewal.
27 (2) An authorized officer or employee of the agency
28 may make unannounced inspections of clinics licensed pursuant
29 to this part as are necessary to determine that the clinic is
30 in compliance with this part and with applicable rules. A
31 licensed clinic shall allow full and complete access to the
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1 premises and to billing records or information to any
2 representative of the agency who makes an inspection to
3 determine compliance with this part and with applicable rules.
4 (1)(3) Failure by a clinic licensed under this part to
5 allow full and complete access to the premises and to billing
6 records or information to any representative of the agency who
7 makes a request to inspect the clinic to determine compliance
8 with this part or failure by a clinic to employ a qualified
9 medical director or clinic director constitutes a ground for
10 emergency suspension of the license by the agency pursuant to
11 s. 408.814 s. 120.60(6).
12 (2)(4) In addition to any administrative fines imposed
13 pursuant to this part or part II of chapter 408, the agency
14 may assess a fee equal to the cost of conducting a complaint
15 investigation.
16 Section 127. Section 400.992, Florida Statutes, is
17 repealed.
18 Section 128. Section 400.9925, Florida Statutes, is
19 amended to read:
20 400.9925 Rulemaking authority; license fees.--
21 (1) The agency shall adopt rules necessary to
22 administer the clinic administration, regulation, and
23 licensure program, including rules pursuant to this part and
24 part II of chapter 408, establishing the specific licensure
25 requirements, procedures, forms, and fees. It shall adopt
26 rules establishing a procedure for the biennial renewal of
27 licenses. The agency may issue initial licenses for less than
28 the full 2-year period by charging a prorated licensure fee
29 and specifying a different renewal date than would otherwise
30 be required for biennial licensure. The rules shall specify
31 the expiration dates of licenses, the process of tracking
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1 compliance with financial responsibility requirements, and any
2 other conditions of renewal required by law or rule.
3 (2) The agency shall adopt rules specifying
4 limitations on the number of licensed clinics and licensees
5 for which a medical director or a clinic director may assume
6 responsibility for purposes of this part. In determining the
7 quality of supervision a medical director or a clinic director
8 can provide, the agency shall consider the number of clinic
9 employees, the clinic location, and the health care services
10 provided by the clinic.
11 (3) In accordance with s. 408.805, an applicant or a
12 licensee shall pay a fee for each license application
13 submitted under this part, part II of chapter 408, and
14 applicable rules. The amount of the fee shall be established
15 by rule and may not exceed $2,000. License application and
16 renewal fees must be reasonably calculated by the agency to
17 cover its costs in carrying out its responsibilities under
18 this part, including the cost of licensure, inspection, and
19 regulation of clinics, and must be of such amount that the
20 total fees collected do not exceed the cost of administering
21 and enforcing compliance with this part. Clinic licensure fees
22 are nonrefundable and may not exceed $2,000. The agency shall
23 adjust the license fee annually by not more than the change in
24 the Consumer Price Index based on the 12 months immediately
25 preceding the increase. All fees collected under this part
26 must be deposited in the Health Care Trust Fund for the
27 administration of this part.
28 Section 129. Section 400.993, Florida Statutes, is
29 amended to read:
30 400.993 Unlicensed clinics; reporting penalties;
31 fines; verification of licensure status.--
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1 (1) It is unlawful to own, operate, or maintain a
2 clinic without obtaining a license under this part.
3 (1)(2) Any person who violates s. 408.812 regarding
4 unlicensed activity owns, operates, or maintains an unlicensed
5 clinic commits a felony of the third degree, punishable as
6 provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
7 continued operation is a separate offense.
8 (2)(3) Any person found guilty of violating s. 408.812
9 subsection (2) a second or subsequent time commits a felony of
10 the second degree, punishable as provided under s. 775.082, s.
11 775.083, or s. 775.084. Each day of continued operation is a
12 separate offense.
13 (4) Any person who owns, operates, or maintains an
14 unlicensed clinic due to a change in this part or a
15 modification in agency rules within 6 months after the
16 effective date of such change or modification and who, within
17 10 working days after receiving notification from the agency,
18 fails to cease operation or apply for a license under this
19 part commits a felony of the third degree, punishable as
20 provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
21 continued operation is a separate offense.
22 (5) Any clinic that fails to cease operation after
23 agency notification may be fined for each day of noncompliance
24 pursuant to this part.
25 (6) When a person has an interest in more than one
26 clinic, and fails to obtain a license for any one of these
27 clinics, the agency may revoke the license, impose a
28 moratorium, or impose a fine pursuant to this part on any or
29 all of the licensed clinics until such time as the unlicensed
30 clinic is licensed or ceases operation.
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1 (7) Any person aware of the operation of an unlicensed
2 clinic must report that facility to the agency.
3 (3)(8) In addition to the requirements of part II of
4 chapter 408, any health care provider who is aware of the
5 operation of an unlicensed clinic shall report that facility
6 to the agency. Failure to report a clinic that the provider
7 knows or has reasonable cause to suspect is unlicensed shall
8 be reported to the provider's licensing board.
9 (9) The agency may not issue a license to a clinic
10 that has any unpaid fines assessed under this part.
11 Section 130. Section 400.9935, Florida Statutes, is
12 amended to read:
13 400.9935 Clinic responsibilities.--
14 (1) Each clinic shall appoint a medical director or
15 clinic director who shall agree in writing to accept legal
16 responsibility for the following activities on behalf of the
17 clinic. The medical director or the clinic director shall:
18 (a) Have signs identifying the medical director or
19 clinic director posted in a conspicuous location within the
20 clinic readily visible to all patients.
21 (b) Ensure that all practitioners providing health
22 care services or supplies to patients maintain a current
23 active and unencumbered Florida license.
24 (c) Review any patient referral contracts or
25 agreements executed by the clinic.
26 (d) Ensure that all health care practitioners at the
27 clinic have active appropriate certification or licensure for
28 the level of care being provided.
29 (e) Serve as the clinic records owner as defined in s.
30 456.057.
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1 (f) Ensure compliance with the recordkeeping, office
2 surgery, and adverse incident reporting requirements of
3 chapter 456, the respective practice acts, and rules adopted
4 under this part and part II of chapter 408.
5 (g) Conduct systematic reviews of clinic billings to
6 ensure that the billings are not fraudulent or unlawful. Upon
7 discovery of an unlawful charge, the medical director or
8 clinic director shall take immediate corrective action. If the
9 clinic performs only the technical component of magnetic
10 resonance imaging, static radiographs, computed tomography, or
11 positron emission tomography, and provides the professional
12 interpretation of such services, in a fixed facility that is
13 accredited by the Joint Commission on Accreditation of
14 Healthcare Organizations or the Accreditation Association for
15 Ambulatory Health Care, and the American College of Radiology;
16 and if, in the preceding quarter, the percentage of scans
17 performed by that clinic which was billed to all personal
18 injury protection insurance carriers was less than 15 percent,
19 the chief financial officer of the clinic may, in a written
20 acknowledgment provided to the agency, assume the
21 responsibility for the conduct of the systematic reviews of
22 clinic billings to ensure that the billings are not fraudulent
23 or unlawful.
24 (h) Not refer a patient to the clinic if the clinic
25 performs magnetic resonance imaging, static radiographs,
26 computed tomography, or positron emission tomography. The term
27 "refer a patient" means the referral of one or more patients
28 of the medical or clinical director or a member of the medical
29 or clinical director's group practice to the clinic for
30 magnetic resonance imaging, static radiographs, computed
31 tomography, or positron emission tomography. A medical
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1 director who is found to violate this paragraph commits a
2 felony of the third degree, punishable as provided in s.
3 775.082, s. 775.083, or s. 775.084.
4 (2) Any business that becomes a clinic after
5 commencing operations must, within 5 days after becoming a
6 clinic, file a license application under this part and shall
7 be subject to all provisions of this part applicable to a
8 clinic.
9 (2)(3) Any contract to serve as a medical director or
10 a clinic director entered into or renewed by a physician or a
11 licensed health care practitioner in violation of this part is
12 void as contrary to public policy. This subsection shall apply
13 to contracts entered into or renewed on or after March 1,
14 2004.
15 (3)(4) All charges or reimbursement claims made by or
16 on behalf of a clinic that is required to be licensed under
17 this part, but that is not so licensed, or that is otherwise
18 operating in violation of this part, are unlawful charges, and
19 therefore are noncompensable and unenforceable.
20 (4)(5) In addition to the requirements of s. 408.812,
21 any person establishing, operating, or managing an unlicensed
22 clinic otherwise required to be licensed under this part or
23 part II of chapter 408, or any person who knowingly files a
24 false or misleading license application or license renewal
25 application, or false or misleading information related to
26 such application or department rule, commits a felony of the
27 third degree, punishable as provided in s. 775.082, s.
28 775.083, or s. 775.084.
29 (5)(6) Any licensed health care provider who violates
30 this part is subject to discipline in accordance with this
31 chapter and his or her respective practice act.
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1 (7) The agency may fine, or suspend or revoke the
2 license of, any clinic licensed under this part for operating
3 in violation of the requirements of this part or the rules
4 adopted by the agency.
5 (8) The agency shall investigate allegations of
6 noncompliance with this part and the rules adopted under this
7 part.
8 (6)(9) Any person or entity providing health care
9 services which is not a clinic, as defined under s. 400.9905,
10 may voluntarily apply for a certificate of exemption from
11 licensure under its exempt status with the agency on a form
12 that sets forth its name or names and addresses, a statement
13 of the reasons why it cannot be defined as a clinic, and other
14 information deemed necessary by the agency. An exemption is
15 not transferable. The agency may charge an applicant for a
16 certificate of exemption in an amount equal to $100 or the
17 actual cost of processing the certificate, whichever is less.
18 (10) The clinic shall display its license in a
19 conspicuous location within the clinic readily visible to all
20 patients.
21 (7)(11)(a) Each clinic engaged in magnetic resonance
22 imaging services must be accredited by the Joint Commission on
23 Accreditation of Healthcare Organizations, the American
24 College of Radiology, or the Accreditation Association for
25 Ambulatory Health Care, within 1 year after licensure.
26 However, a clinic may request a single, 6-month extension if
27 it provides evidence to the agency establishing that, for good
28 cause shown, such clinic can not be accredited within 1 year
29 after licensure, and that such accreditation will be completed
30 within the 6-month extension. After obtaining accreditation as
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1 required by this subsection, each such clinic must maintain
2 accreditation as a condition of renewal of its license.
3 (b) The agency may deny the application or revoke the
4 license of any entity formed for the purpose of avoiding
5 compliance with the accreditation provisions of this
6 subsection and whose principals were previously principals of
7 an entity that was unable to meet the accreditation
8 requirements within the specified timeframes. The agency may
9 adopt rules as to the accreditation of magnetic resonance
10 imaging clinics.
11 (8)(12) The agency shall give full faith and credit
12 pertaining to any past variance and waiver granted to a
13 magnetic resonance imaging clinic from rule 64-2002, Florida
14 Administrative Code, by the Department of Health, until
15 September 2004. After that date, such clinic must request a
16 variance and waiver from the agency under s. 120.542.
17 (9)(13) In addition to the requirements of part II of
18 chapter 408, the clinic shall display a sign in a conspicuous
19 location within the clinic readily visible to all patients
20 indicating that, pursuant to s. 626.9892, the Department of
21 Financial Services may pay rewards of up to $25,000 to persons
22 providing information leading to the arrest and conviction of
23 persons committing crimes investigated by the Division of
24 Insurance Fraud arising from violations of s. 440.105, s.
25 624.15, s. 626.9541, s. 626.989, or s. 817.234. An authorized
26 employee of the Division of Insurance Fraud may make
27 unannounced inspections of a clinic licensed under this part
28 as necessary to determine whether the clinic is in compliance
29 with this subsection. A licensed clinic shall allow full and
30 complete access to the premises to such authorized employee of
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1 the division who makes an inspection to determine compliance
2 with this subsection.
3 Section 131. Section 400.994, Florida Statutes, is
4 repealed.
5 Section 132. Section 400.9945, Florida Statutes, is
6 repealed.
7 Section 133. Section 400.995, Florida Statutes, is
8 amended to read:
9 400.995 Agency administrative penalties.--
10 (1) In addition to the requirements of part II of
11 chapter 408, the agency may deny the application for a license
12 renewal, revoke and or suspend the license, and impose
13 administrative fines of up to $5,000 per violation for
14 violations of the requirements of this part or rules of the
15 agency. In determining if a penalty is to be imposed and in
16 fixing the amount of the fine, the agency shall consider the
17 following factors:
18 (a) The gravity of the violation, including the
19 probability that death or serious physical or emotional harm
20 to a patient will result or has resulted, the severity of the
21 action or potential harm, and the extent to which the
22 provisions of the applicable laws or rules were violated.
23 (b) Actions taken by the owner, medical director, or
24 clinic director to correct violations.
25 (c) Any previous violations.
26 (d) The financial benefit to the clinic of committing
27 or continuing the violation.
28 (2) Each day of continuing violation after the date
29 fixed for termination of the violation, as ordered by the
30 agency, constitutes an additional, separate, and distinct
31 violation.
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1 (3) Any action taken to correct a violation shall be
2 documented in writing by the owner, medical director, or
3 clinic director of the clinic and verified through followup
4 visits by agency personnel. The agency may impose a fine and,
5 in the case of an owner-operated clinic, revoke or deny a
6 clinic's license when a clinic medical director or clinic
7 director knowingly misrepresents actions taken to correct a
8 violation.
9 (4) For fines that are upheld following administrative
10 or judicial review, the violator shall pay the fine, plus
11 interest at the rate as specified in s. 55.03, for each day
12 beyond the date set by the agency for payment of the fine.
13 (5) Any unlicensed clinic that continues to operate
14 after agency notification is subject to a $1,000 fine per day.
15 (4)(6) Any licensed clinic whose owner, medical
16 director, or clinic director concurrently operates an
17 unlicensed clinic shall be subject to an administrative fine
18 of $5,000 per day.
19 (5)(7) Any clinic whose owner fails to apply for a
20 change-of-ownership license in accordance with s. 400.992 and
21 operates the clinic under the new ownership is subject to a
22 fine of $5,000.
23 (6)(8) The agency, as an alternative to or in
24 conjunction with an administrative action against a clinic for
25 violations of this part and adopted rules, shall make a
26 reasonable attempt to discuss each violation and recommended
27 corrective action with the owner, medical director, or clinic
28 director of the clinic, prior to written notification. The
29 agency, instead of fixing a period within which the clinic
30 shall enter into compliance with standards, may request a plan
31 of corrective action from the clinic which demonstrates a good
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1 faith effort to remedy each violation by a specific date,
2 subject to the approval of the agency.
3 (9) Administrative fines paid by any clinic under this
4 section shall be deposited into the Health Care Trust Fund.
5 (10) If the agency issues a notice of intent to deny a
6 license application after a temporary license has been issued
7 pursuant to s. 400.991(3), the temporary license shall expire
8 on the date of the notice and may not be extended during any
9 proceeding for administrative or judicial review pursuant to
10 chapter 120.
11 Section 134. Section 408.802, Florida Statutes, is
12 amended to read:
13 408.802 Applicability.--The provisions of this part
14 apply to the provision of services that require licensure as
15 defined in this part and to the following entities licensed,
16 registered, or certified by the agency, as described in
17 chapters 112, 383, 390, 394, 395, 400, 429, 440, 483, and 765:
18 (1) Laboratories authorized to perform testing under
19 the Drug-Free Workplace Act, as provided under ss. 112.0455
20 and 440.102.
21 (2) Birth centers, as provided under chapter 383.
22 (3) Abortion clinics, as provided under chapter 390.
23 (4) Crisis stabilization units, as provided under
24 parts I and IV of chapter 394.
25 (5) Short-term residential treatment facilities, as
26 provided under parts I and IV of chapter 394.
27 (6) Residential treatment facilities, as provided
28 under part IV of chapter 394.
29 (7) Residential treatment centers for children and
30 adolescents, as provided under part IV of chapter 394.
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1 (8) Hospitals, as provided under part I of chapter
2 395.
3 (9) Ambulatory surgical centers, as provided under
4 part I of chapter 395.
5 (10) Mobile surgical facilities, as provided under
6 part I of chapter 395.
7 (11) Private review agents, as provided under part I
8 of chapter 395.
9 (12) Health care risk managers, as provided under part
10 I of chapter 395.
11 (13) Nursing homes, as provided under part II of
12 chapter 400.
13 (14) Assisted living facilities, as provided under
14 part I III of chapter 429 400.
15 (15) Home health agencies, as provided under part III
16 IV of chapter 400.
17 (16) Nurse registries, as provided under part III IV
18 of chapter 400.
19 (17) Companion services or homemaker services
20 providers, as provided under part III IV of chapter 400.
21 (18) Adult day care centers, as provided under part
22 III V of chapter 429 400.
23 (19) Hospices, as provided under part IV VI of chapter
24 400.
25 (20) Adult family-care homes, as provided under part
26 II VII of chapter 429 400.
27 (21) Homes for special services, as provided under
28 part V VIII of chapter 400.
29 (22) Transitional living facilities, as provided under
30 part V VIII of chapter 400.
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1 (23) Prescribed pediatric extended care centers, as
2 provided under part VI IX of chapter 400.
3 (24) Home medical equipment providers, as provided
4 under part VII X of chapter 400.
5 (25) Intermediate care facilities for persons with
6 developmental disabilities, as provided under part VIII XI of
7 chapter 400.
8 (26) Health care services pools, as provided under
9 part IX XII of chapter 400.
10 (27) Health care clinics, as provided under part X
11 XIII of chapter 400.
12 (28) Clinical laboratories, as provided under part I
13 of chapter 483.
14 (29) Multiphasic health testing centers, as provided
15 under part II of chapter 483.
16 (30) Organ and tissue procurement agencies, as
17 provided under chapter 765.
18 Section 135. Section 408.832, Florida Statutes, is
19 amended to read:
20 408.832 Conflicts.--In case of conflict between the
21 provisions of part II of chapter 408 and the authorizing
22 statutes governing the licensure of health care providers by
23 the Agency for Health Care Administration found in s. 112.0455
24 and chapters 383, 390, 394, 395, 400, 429, 440, 483, and 765,
25 the provisions of part II of chapter 408 shall prevail.
26 Section 136. Paragraph (e) of subsection (4) of
27 section 409.221, Florida Statutes, is amended to read:
28 409.221 Consumer-directed care program.--
29 (4) CONSUMER-DIRECTED CARE.--
30 (e) Services.--Consumers shall use the budget
31 allowance only to pay for home and community-based services
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1 that meet the consumer's long-term care needs and are a
2 cost-efficient use of funds. Such services may include, but
3 are not limited to, the following:
4 1. Personal care.
5 2. Homemaking and chores, including housework, meals,
6 shopping, and transportation.
7 3. Home modifications and assistive devices which may
8 increase the consumer's independence or make it possible to
9 avoid institutional placement.
10 4. Assistance in taking self-administered medication.
11 5. Day care and respite care services, including those
12 provided by nursing home facilities pursuant to s. 400.141(6)
13 or by adult day care facilities licensed pursuant to s.
14 429.907 400.554.
15 6. Personal care and support services provided in an
16 assisted living facility.
17 Section 137. Paragraph (g) of subsection (2) of
18 section 409.815, Florida Statutes, is amended to read:
19 409.815 Health benefits coverage; limitations.--
20 (2) BENCHMARK BENEFITS.--In order for health benefits
21 coverage to qualify for premium assistance payments for an
22 eligible child under ss. 409.810-409.820, the health benefits
23 coverage, except for coverage under Medicaid and Medikids,
24 must include the following minimum benefits, as medically
25 necessary.
26 (g) Behavioral health services.--
27 1. Mental health benefits include:
28 a. Inpatient services, limited to not more than 30
29 inpatient days per contract year for psychiatric admissions,
30 or residential services in facilities licensed under s.
31 394.875(6)(8) or s. 395.003 in lieu of inpatient psychiatric
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1 admissions; however, a minimum of 10 of the 30 days shall be
2 available only for inpatient psychiatric services when
3 authorized by a physician; and
4 b. Outpatient services, including outpatient visits
5 for psychological or psychiatric evaluation, diagnosis, and
6 treatment by a licensed mental health professional, limited to
7 a maximum of 40 outpatient visits each contract year.
8 2. Substance abuse services include:
9 a. Inpatient services, limited to not more than 7
10 inpatient days per contract year for medical detoxification
11 only and 30 days of residential services; and
12 b. Outpatient services, including evaluation,
13 diagnosis, and treatment by a licensed practitioner, limited
14 to a maximum of 40 outpatient visits per contract year.
15 Section 138. Subsection (8) of section 409.905,
16 Florida Statutes, is amended to read:
17 409.905 Mandatory Medicaid services.--The agency may
18 make payments for the following services, which are required
19 of the state by Title XIX of the Social Security Act,
20 furnished by Medicaid providers to recipients who are
21 determined to be eligible on the dates on which the services
22 were provided. Any service under this section shall be
23 provided only when medically necessary and in accordance with
24 state and federal law. Mandatory services rendered by
25 providers in mobile units to Medicaid recipients may be
26 restricted by the agency. Nothing in this section shall be
27 construed to prevent or limit the agency from adjusting fees,
28 reimbursement rates, lengths of stay, number of visits, number
29 of services, or any other adjustments necessary to comply with
30 the availability of moneys and any limitations or directions
31 provided for in the General Appropriations Act or chapter 216.
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1 (8) NURSING FACILITY SERVICES.--The agency shall pay
2 for 24-hour-a-day nursing and rehabilitative services for a
3 recipient in a nursing facility licensed under part II of
4 chapter 400 or in a rural hospital, as defined in s. 395.602,
5 or in a Medicare certified skilled nursing facility operated
6 by a hospital, as defined by s. 395.002(10)(11), that is
7 licensed under part I of chapter 395, and in accordance with
8 provisions set forth in s. 409.908(2)(a), which services are
9 ordered by and provided under the direction of a licensed
10 physician. However, if a nursing facility has been destroyed
11 or otherwise made uninhabitable by natural disaster or other
12 emergency and another nursing facility is not available, the
13 agency must pay for similar services temporarily in a hospital
14 licensed under part I of chapter 395 provided federal funding
15 is approved and available. The agency shall pay only for
16 bed-hold days if the facility has an occupancy rate of 95
17 percent or greater. The agency is authorized to seek any
18 federal waivers to implement this policy.
19 Section 139. Subsection (7) of section 409.907,
20 Florida Statutes, is amended to read:
21 409.907 Medicaid provider agreements.--The agency may
22 make payments for medical assistance and related services
23 rendered to Medicaid recipients only to an individual or
24 entity who has a provider agreement in effect with the agency,
25 who is performing services or supplying goods in accordance
26 with federal, state, and local law, and who agrees that no
27 person shall, on the grounds of handicap, race, color, or
28 national origin, or for any other reason, be subjected to
29 discrimination under any program or activity for which the
30 provider receives payment from the agency.
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1 (7) The agency may require, as a condition of
2 participating in the Medicaid program and before entering into
3 the provider agreement, that the provider submit information,
4 in an initial and any required renewal applications,
5 concerning the professional, business, and personal background
6 of the provider and permit an onsite inspection of the
7 provider's service location by agency staff or other personnel
8 designated by the agency to perform this function. The agency
9 shall perform a random onsite inspection, within 60 days after
10 receipt of a fully complete new provider's application, of the
11 provider's service location prior to making its first payment
12 to the provider for Medicaid services to determine the
13 applicant's ability to provide the services that the applicant
14 is proposing to provide for Medicaid reimbursement. The agency
15 is not required to perform an onsite inspection of a provider
16 or program that is licensed by the agency, that provides
17 services under waiver programs for home and community-based
18 services, or that is licensed as a medical foster home by the
19 Department of Children and Family Services. As a continuing
20 condition of participation in the Medicaid program, a provider
21 shall immediately notify the agency of any current or pending
22 bankruptcy filing. Before entering into the provider
23 agreement, or as a condition of continuing participation in
24 the Medicaid program, the agency may also require that
25 Medicaid providers reimbursed on a fee-for-services basis or
26 fee schedule basis which is not cost-based, post a surety bond
27 not to exceed $50,000 or the total amount billed by the
28 provider to the program during the current or most recent
29 calendar year, whichever is greater. For new providers, the
30 amount of the surety bond shall be determined by the agency
31 based on the provider's estimate of its first year's billing.
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1 If the provider's billing during the first year exceeds the
2 bond amount, the agency may require the provider to acquire an
3 additional bond equal to the actual billing level of the
4 provider. A provider's bond shall not exceed $50,000 if a
5 physician or group of physicians licensed under chapter 458,
6 chapter 459, or chapter 460 has a 50 percent or greater
7 ownership interest in the provider or if the provider is an
8 assisted living facility licensed under chapter 429. The bonds
9 permitted by this section are in addition to the bonds
10 referenced in s. 400.179(2)(5)(d). If the provider is a
11 corporation, partnership, association, or other entity, the
12 agency may require the provider to submit information
13 concerning the background of that entity and of any principal
14 of the entity, including any partner or shareholder having an
15 ownership interest in the entity equal to 5 percent or
16 greater, and any treating provider who participates in or
17 intends to participate in Medicaid through the entity. The
18 information must include:
19 (a) Proof of holding a valid license or operating
20 certificate, as applicable, if required by the state or local
21 jurisdiction in which the provider is located or if required
22 by the Federal Government.
23 (b) Information concerning any prior violation, fine,
24 suspension, termination, or other administrative action taken
25 under the Medicaid laws, rules, or regulations of this state
26 or of any other state or the Federal Government; any prior
27 violation of the laws, rules, or regulations relating to the
28 Medicare program; any prior violation of the rules or
29 regulations of any other public or private insurer; and any
30 prior violation of the laws, rules, or regulations of any
31 regulatory body of this or any other state.
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1 (c) Full and accurate disclosure of any financial or
2 ownership interest that the provider, or any principal,
3 partner, or major shareholder thereof, may hold in any other
4 Medicaid provider or health care related entity or any other
5 entity that is licensed by the state to provide health or
6 residential care and treatment to persons.
7 (d) If a group provider, identification of all members
8 of the group and attestation that all members of the group are
9 enrolled in or have applied to enroll in the Medicaid program.
10 Section 140. Subsections (6) through (27) of section
11 429.02, Florida Statutes, are renumbered as subsections (5)
12 through (26), respectively, and present subsections (5) and
13 (12) of that section are amended to read:
14 429.02 Definitions.--When used in this part, the term:
15 (5) "Applicant" means an individual owner,
16 corporation, partnership, firm, association, or governmental
17 entity that applies for a license.
18 (11)(12) "Extended congregate care" means acts beyond
19 those authorized in subsection (16) (17) that may be performed
20 pursuant to part I of chapter 464 by persons licensed
21 thereunder while carrying out their professional duties, and
22 other supportive services which may be specified by rule. The
23 purpose of such services is to enable residents to age in
24 place in a residential environment despite mental or physical
25 limitations that might otherwise disqualify them from
26 residency in a facility licensed under this part.
27 Section 141. Section 429.07, Florida Statutes, is
28 amended to read:
29 429.07 License required; fee, display.--
30 (1) The requirements of part II of chapter 408 apply
31 to the provision of services that require licensure pursuant
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1 to this part and part II of chapter 408 and to entities
2 licensed by or applying for such licensure from the agency
3 pursuant to this part. A license issued by the agency is
4 required in order to operate for an assisted living facility
5 operating in this state.
6 (2) Separate licenses shall be required for facilities
7 maintained in separate premises, even though operated under
8 the same management. A separate license shall not be required
9 for separate buildings on the same grounds.
10 (3) In addition to the requirements of s. 408.806,
11 each Any license granted by the agency must state the maximum
12 resident capacity of the facility, the type of care for which
13 the license is granted, the date the license is issued, the
14 expiration date of the license, and any other information
15 deemed necessary by the agency. Licenses shall be issued for
16 one or more of the following categories of care: standard,
17 extended congregate care, limited nursing services, or limited
18 mental health.
19 (a) A standard license shall be issued to facilities
20 providing one or more of the personal services identified in
21 s. 429.02. Such facilities may also employ or contract with a
22 person licensed under part I of chapter 464 to administer
23 medications and perform other tasks as specified in s.
24 429.255.
25 (b) An extended congregate care license shall be
26 issued to facilities providing, directly or through contract,
27 services beyond those authorized in paragraph (a), including
28 acts performed pursuant to part I of chapter 464 by persons
29 licensed thereunder, and supportive services defined by rule
30 to persons who otherwise would be disqualified from continued
31 residence in a facility licensed under this part.
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