Florida Senate - 2008 SB 1186
By Senator Rich
34-02519A-08 20081186__
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A bill to be entitled
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An act relating to decisionmaking in health care;
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providing a short title; providing legislative purpose;
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amending s. 408.063, F.S.; providing definitions;
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requiring the Agency for Health Care Administration to
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publish and disseminate to the public information
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concerning violations of federal regulations, complaints
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made to regulatory agencies, and nurse staffing levels and
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turnover rates; requiring the agency to adopt rules
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governing the data to be submitted by hospitals; requiring
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the agency to calculate and make available upon request
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hospital staffing levels and staffing schedules; providing
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certain requirements for the staffing schedule; requiring
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that the records and methods used to determine staffing
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levels be made available to the public; providing an
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effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. This act may be cited as the "Patients' Right-
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to-Know Act."
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Section 2. The purpose of this act is to improve health
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care in this state by providing information concerning the
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financial health, staffing levels, and safety of hospitals in
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this state.
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Section 3. Subsection (2) of section 408.063, Florida
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Statutes, is amended to read:
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408.063 Dissemination of health care information.--
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(2)(a) As used in this subsection, the term:
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1. "Agency nurse" means any direct-care nurse, not directly
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employed by the hospital, who provides care in a hospital and is
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working for the purpose of providing supplemental staffing in the
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hospital.
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2. "Average daily census" means the average number of
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patients receiving service in any given 24-hour period beginning
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at midnight in each clinical service area of the hospital.
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3. "Average daily CNA staffing level" means the average
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numerical certified nursing assistant-to-patient ratio within a
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nursing department or unit. The ratio is calculated by dividing
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the annual average daily census for the nursing department or
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unit by the average number of direct-care CNA FTE's per shift for
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the nursing department or unit.
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4. "Average daily LPN staffing level" means the average
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numerical licensed professional nurse-to-patient ratio within a
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nursing department or unit. The ratio is calculated by dividing
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the annual average daily census for the nursing department or
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unit by the average number of direct-care LPN FTE's per shift for
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the nursing department or unit.
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5. "Average daily RN staffing level" means the average
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numerical direct-care nurse-to-patient ratio within a nursing
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department or unit. The ratio is calculated by dividing the
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annual average daily census for the nursing department or unit by
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the average number of direct-care RN FTE's per shift for the
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nursing department or unit.
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6. "Direct-care nurse" means any registered nurse who has
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direct responsibility to oversee or carry out medical regimens or
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nursing care for one or more patients. A nurse administrator,
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nurse supervisor, nurse educator, charge nurse, or other
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registered nurse who does not have a specific patient assignment
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may not be included in the calculation of the staffing level.
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7. "Hospital" means an acute care hospital licensed under
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s. 395.003.
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8. "Registered nurse turnover rate" means the number of
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registered nurses who are no longer employed at the hospital
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during the year divided by the average of registered nurses
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employed on the first day of the year and the last day of the
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year.
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9. "Registered nurse vacancy rate" means the number of
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vacant registered nurse positions within a hospital divided by
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the total number of filled positions plus the total number of
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vacant positions within that hospital.
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10. "Unit" means a functional division or area of a
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hospital in which nursing care is provided.
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(b) The agency shall publish and disseminate information to
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the public which will enhance informed decisionmaking in the
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selection of health care providers, facilities, and services.
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Such information shall include, but need not be limited to, the
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number and description of violations of regulations of the
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Occupational Safety and Health Administration, the registered
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nurse vacancy rate, the registered nurse turnover rate, the
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results of the Consumer Assessment of Healthcare Providers and
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Systems hospital survey, the number and description of complaints
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made to the Joint Commission on Accreditation of Healthcare
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Organizations and the Agency for Health Care Administration,
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specific average daily RN staffing levels, specific average daily
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LPN staffing levels, specific average daily CNA levels, and the
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percent of nursing hours that are completed by agency nurses for
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the following hospital units: medical-surgical, adult critical
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care, pediatrics, pediatric intensive care, neonatal intensive
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care, trauma intensive care, mother-baby unit, psychiatric unit,
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ambulatory care and outpatient, dialysis, cardiac catheterization
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laboratory, operating room, medical oncology, burn unit,
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transplant unit, rehabilitation unit, gastrointestinal
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laboratory, emergency, telemetry, and recovery unit, including
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postanesthesia care. Such publications may identify average
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charges for specified services, lengths of stay associated with
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established diagnostic groups, readmission rates, mortality
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rates, recommended guidelines for selection and use of health
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care providers, health care facilities, and health care services,
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and such other information as the agency deems appropriate.
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(c) The agency shall adopt rules regarding the reporting
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requirements enumerated in this subsection, including, but not
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limited to, additional data to be submitted by hospitals and the
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format and timetable for making reports. The agency may calculate
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and make available the average daily staffing levels by unit in a
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manner that health care research has shown to have a significant
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effect on the quality of patient care and patient outcomes.
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(d) The agency shall ensure that the nurse-staffing data
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made available pursuant to paragraph (c) is risk-adjusted for
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patient acuity using the risk-adjustment methodology described in
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s. 408.061(1) or an equivalent methodology that is consistent
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with national standards employed by the Agency for Healthcare
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Research and Quality.
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(e) The current staffing level and anticipated staffing
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schedule shall be available upon request for each patient care
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unit for the effective date of that schedule. Each schedule shall
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list the assigned nursing personnel and the average daily census
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for each patient care unit. All records required under this
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subsection, including anticipated staffing schedules and the
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methods used to determine and adjust staffing levels, shall be
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made available to the public upon request.
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Section 4. This act shall take effect July 1, 2008.
CODING: Words stricken are deletions; words underlined are additions.