HB 1335

1	A bill to be entitled
2	An act relating to long-term care facilities; providing a
3	short title; amending s. 400.021, F.S.; providing
4	definitions; amending s. 400.071, F.S.; requiring
5	additional information to be submitted with an application
6	for a nursing home facility license; amending s. 400.102,
7	F.S.; providing additional grounds for action by the
8	Agency for Health Care Administration against a licensee;
9	amending s. 400.111, F.S.; requiring licensees to disclose
10	financial or ownership interests acquired by certain
11	entities within a specified period of time; amending s.
12	400.121, F.S.; specifying additional circumstances under
13	which the agency may deny, revoke, or suspend a facility's
14	license or impose a fine; amending s. 400.141, F.S.;
15	prohibiting the use of liability insurance for litigation
16	costs or attorney's fees under certain circumstances;
17	requiring the licensee to notify the agency when policy
18	limits are exhausted; amending s. 400.191, F.S.;
19	specifying additional information that must be included on
20	the agency's Internet website; requiring the posting in
21	the nursing home of a copy of the conditional license;
22	creating s. 400.197, F.S.; requiring nursing home
23	licensees to provide notice of a change of ownership to
24	the agency and specified persons; requiring the licensee
25	to post the notice in writing and on its Internet website;
26	providing for certain affected parties to submit
27	information to the agency regarding the applicant for
28	ownership; authorizing the agency to investigate the
29	applicant; requiring the licensee to assume certain
30	liabilities if the agency grants a change of ownership;
31	amending s. 419.001, F.S.; revising provisions restricting
32	the siting of community residential homes; amending s.
33	429.02, F.S.; providing definitions; amending s. 429.11,
34	F.S.; requiring additional information to be submitted
35	with an application for an assisted living facility
36	license; prohibiting the use of liability insurance for
37	litigation costs or attorney's fees under certain
38	circumstances; requiring licensees to disclose financial
39	or ownership interests acquired by certain entities within
40	a specified period of time; amending s. 429.12, F.S.;
41	requiring assisted living facility licensees to provide
42	notice of a change of ownership to the agency and
43	specified persons; requiring the licensee to post the
44	notice in writing and on its Internet website; providing
45	for certain affected parties to submit information to the
46	agency regarding the applicant for ownership; authorizing
47	the agency to investigate the applicant; requiring the
48	licensee to assume certain liabilities if the agency
49	grants a change of ownership; amending s. 429.14, F.S.;
50	specifying additional circumstances under which the agency
51	may deny, revoke, or suspend a facility's license or
52	impose a fine; requiring the posting in the facility of
53	notice of the issuance of a conditional license; amending
54	s. 429.174, F.S.; conforming a cross-reference; amending
55	s. 429.275, F.S.; prohibiting the use of liability
56	insurance for litigation costs or attorney's fees under
57	certain circumstances; requiring the administrator or
58	facility owner to notify the agency when policy limits are
59	exhausted; providing an effective date.
60
61	Be It Enacted by the Legislature of the State of Florida:
62
63	Section 1.  This act may be cited as the "Long-term Care
64	Transparency Act."
65	Section 2.  Present subsections (2) through (4) of section
66	400.021, Florida Statutes, are renumbered as subsections (3)
67	through (5), respectively, present subsections (5) and (6) are
68	renumbered as subsections (8) and (9), respectively, present
69	subsections (7) through (9) are renumbered as subsections (11)
70	through (13), respectively, present subsections (10) through
71	(18) are renumbered as subsections (15) through (23),
72	respectively, and new subsections (2), (6), (7), (10), and (14)
73	are added to that section to read:
74	400.021  Definitions.--When used in this part, unless the
75	context otherwise requires, the term:
76	(2)  "Affiliated entity" means any entity, entities, or
77	persons with the same or similar officers, board members,
78	directors, limited liability company members, operating company,
79	management company, or addresses.
80	(6)  "Controlling entity" means any entity, entities, or
81	persons that exhibit any indicia of control over the licensee or
82	applicant, including, but not limited to, control over resident
83	care, a facility's budget, or staffing levels; setting or
84	monitoring census goals; power over or responsibility for
85	employment decisions, capital purchases, facility improvements,
86	or plant improvements; access to or use of the licensee's or
87	applicant's assets, equipment, or financing or lending
88	agreements; or influence over the business decisions of the
89	licensee or applicant.
90	(7)  "Controlling financial interest" means any entity that
91	has a 5 percent or greater financial or ownership interest in
92	the licensee, an affiliated entity, or a controlling entity.
93	(10)  "Entity" means an individual, corporation,
94	partnership, association, joint venture, sole proprietorship,
95	limited liability company, professional limited liability
96	company, or any other manner and form of conducting business.
97	(14)  "Governing body" means the individuals responsible
98	for hiring the nursing home administrator, approving the nursing
99	home's policies and procedures, and ensuring the proper
100	implementation of those policies and procedures.
101	Section 3.  Subsection (1) of section 400.071, Florida
102	Statutes, is amended to read:
103	400.071  Application for license.--
104	(1)  In addition to the requirements of part II of chapter
105	408, the application for a license shall be under oath and must
106	contain the following:
107	(a)  The location of the facility for which a license is
108	sought and an indication, as in the original application, that
109	such location conforms to the local zoning ordinances.
110	(b)  A signed affidavit disclosing any financial or
111	ownership interest that the applicant, a controlling financial
112	interest, controlling entity, or affiliated entity as defined in
113	part II of chapter 408 has held in the last 5 years in any
114	entity licensed by this state or any other state to provide
115	health or residential care which has closed voluntarily or
116	involuntarily; has filed for bankruptcy; has had a receiver
117	appointed; has had a license denied, suspended, or revoked; or
118	has had an injunction issued against it which was initiated by a
119	regulatory agency. The affidavit must disclose the reason any
120	such entity was closed, whether voluntarily or involuntarily.
121	(c)  A signed affidavit disclosing any affiliated entities,
122	controlling entities, and controlling financial interests of the
123	licensee.
124	(d)  The total number of beds and the total number of
125	Medicare and Medicaid certified beds.
126	(e)(d)  Information relating to the applicant and employees
127	which the agency requires by rule. The applicant must
128	demonstrate that sufficient numbers of qualified staff, by
129	training or experience, will be employed to properly care for
130	the type and number of residents who will reside in the
131	facility.
132	(f)  An audited financial statement of the applicant if an
133	audited financial statement is prepared for the applicant or the
134	consolidated group. In an application relating to change of
135	ownership of an existing nursing home, financial condition
136	documentation must include, but need not be limited to, a
137	balance sheet and a profit and loss statement of the 2 previous
138	fiscal years' operation.
139	(g)  Proof of financial ability to operate. The applicant
140	must demonstrate an ability to provide staffing at levels
141	required by law and maintain solvency in accordance with the
142	requirements of this part, applicable sections of chapter 408,
143	and applicable rules. Documentation shall include, but is not
144	limited to, a statement of the projected revenue and expenses
145	for the first 12 months of operation following licensure, a
146	detailed explanation of the assumptions implicit in these
147	projections, the basis for financing the anticipated cash-flow
148	requirements of the provider, and the applicant's access to
149	contingency financing.
150	(h)(e)  Copies of any civil verdict or judgment involving
151	the applicant, affiliated entities, or controlling entities
152	rendered within the 10 years preceding the application, relating
153	to medical negligence, violation of residents' rights, or
154	wrongful death. As a condition of licensure, the licensee agrees
155	to provide to the agency copies of any new verdict or judgment
156	involving the applicant, relating to such matters, within 30
157	days after filing with the clerk of the court. The information
158	required in this paragraph shall be maintained in the facility's
159	licensure file and in an agency database which is available as a
160	public record.
161	(i)  Copies of any contracts with affiliated entities or
162	controlling entities, including details of goods and services
163	provided and the intended method of payment for those goods and
164	services.
165	(j)  Copies of any audits, investigations, or fines related
166	to the receipt or use of federal and state funds by all
167	affiliated entities, controlling entities, and controlling
168	financial interests, including the results of or documentation
169	pertaining to any ongoing investigation into Medicaid or
170	Medicare fraud or overpayment, any standing corporate integrity
171	agreements, or other remedial action by any public entity.
172	(k)  The names and dates of service of all members of the
173	facility's governing body.
174	Section 4.  Section 400.102, Florida Statutes, is amended
175	to read:
176	400.102  Action by agency against licensee; grounds.--In
177	addition to the grounds listed in part II of chapter 408, any of
178	the following conditions shall be grounds for action by the
179	agency against a licensee:
180	(1)  An intentional or negligent act materially affecting
181	the health or safety of residents of the facility;
182	(2)  Misappropriation or conversion of the property of a
183	resident of the facility;
184	(3)  Failure to follow the criteria and procedures provided
185	under part I of chapter 394 relating to the transportation,
186	voluntary admission, and involuntary examination of a nursing
187	home resident; or
188	(4)  Fraudulent altering, defacing, or falsifying any
189	medical or nursing home records, or causing or procuring any of
190	these offenses to be committed; or.
191	(5)  Failure to disclose at the time of licensure,
192	relicensure, or change of ownership all affiliated entities,
193	controlling entities, controlling financial interests, and
194	members of the facility's governing body.
195	Section 5.  Section 400.111, Florida Statutes, is amended
196	to read:
197	400.111  Disclosure of controlling financial interest and
198	affiliated or controlling entity.--In addition to the
199	requirements of part II of chapter 408, at the time of
200	licensure, relicensure, or change of ownership, the licensee
201	shall submit a signed affidavit disclosing any financial or
202	ownership financial interest that a controlling interest and any
203	affiliated entity or controlling entity has held within the last
204	5 years in any entity licensed by the state or any other state
205	to provide health or residential care which entity has closed
206	voluntarily or involuntarily; has filed for bankruptcy; has had
207	a receiver appointed; has had a license denied, suspended, or
208	revoked; or has had an injunction issued against it which was
209	initiated by a regulatory agency. The affidavit must disclose
210	the reason such entity was closed, whether voluntarily or
211	involuntarily. As a condition of licensure, relicensure, or
212	change of ownership, the licensee shall provide to the agency a
213	signed affidavit disclosing any financial or ownership interest
214	that an affiliated entity, controlling entity, or controlling
215	financial interest acquires within 30 days after the
216	acquisition.
217	Section 6.  Subsections (1) and (3) of section 400.121,
218	Florida Statutes, are amended to read:
219	400.121  Denial, suspension, revocation of license;
220	administrative fines; procedure; order to increase staffing.--
221	(1)  The agency may deny an application, revoke or suspend
222	a license, and impose an administrative fine, not to exceed $500
223	per violation per day for the violation of any provision of this
224	part, part II of chapter 408, or applicable rules, against any
225	applicant or licensee for the following violations by the
226	applicant, licensee, or other controlling interest:
227	(a)  A violation of any provision of this part, part II of
228	chapter 408, or applicable rules; or
229	(b)  An adverse action by a regulatory agency against any
230	other licensed facility that has a common controlling entity or
231	controlling financial interest with the licensee or applicant
232	against whom the action under this section is being brought. If
233	the adverse action involves solely the management company, the
234	applicant or licensee shall be given 30 days to remedy before
235	final action is taken. If the adverse action is based solely
236	upon actions by a controlling interest, the applicant or
237	licensee may present factors in mitigation of any proposed
238	penalty based upon a showing that such penalty is inappropriate
239	under the circumstances.
240
241	All hearings shall be held within the county in which the
242	licensee or applicant operates or applies for a license to
243	operate a facility as defined herein.
244	(3)  The agency shall revoke or deny a nursing home license
245	if the licensee, a controlling entity, or a controlling
246	financial interest operates a facility in this state that:
247	(a)  Has had two moratoria issued pursuant to this part or
248	part II of chapter 408 which are imposed by final order for
249	substandard quality of care, as defined by 42 C.F.R. part 483,
250	within any 30-month period;
251	(b)  Is conditionally licensed for 180 or more continuous
252	days;
253	(c)  Is cited for two class I deficiencies arising from
254	unrelated circumstances during the same survey or investigation;
255	or
256	(d)  Is cited for two class I deficiencies arising from
257	separate surveys or investigations within a 30-month period.
258
259	The licensee may present factors in mitigation of revocation,
260	and the agency may make a determination not to revoke a license
261	based upon a showing that revocation is inappropriate under the
262	circumstances.
263	Section 7.  Subsection (20) of section 400.141, Florida
264	Statutes, is amended to read:
265	400.141  Administration and management of nursing home
266	facilities.--Every licensed facility shall comply with all
267	applicable standards and rules of the agency and shall:
268	(20)  Maintain general and professional liability insurance
269	coverage that is in force at all times. The required general and
270	professional liability insurance may not be used for litigation
271	costs or attorney's fees for the defense of any claim against a
272	nursing home pursuant to the common law, s. 400.023, or s.
273	400.0233. The licensee shall notify the agency immediately when
274	the policy limits have been exhausted. In lieu of general and
275	professional liability insurance coverage, a state-designated
276	teaching nursing home and its affiliated assisted living
277	facilities created under s. 430.80 may demonstrate proof of
278	financial responsibility as provided in s. 430.80(3)(h).
279
280	Facilities that have been awarded a Gold Seal under the program
281	established in s. 400.235 may develop a plan to provide
282	certified nursing assistant training as prescribed by federal
283	regulations and state rules and may apply to the agency for
284	approval of their program.
285	Section 8.  Subsections (2) and (5) of section 400.191,
286	Florida Statutes, are amended to read:
287	400.191  Availability, distribution, and posting of reports
288	and records.--
289	(2)  The agency shall publish the Nursing Home Guide
290	annually in consumer-friendly printed form and quarterly in
291	electronic form to assist consumers and their families in
292	comparing and evaluating nursing home facilities.
293	(a)  The agency shall provide an Internet website site
294	which shall include at least the following information either
295	directly or indirectly through a link to another established
296	site or sites of the agency's choosing:
297	1.  A section entitled "Have you considered programs that
298	provide alternatives to nursing home care?" which shall be the
299	first section of the Nursing Home Guide and which shall
300	prominently display information about available alternatives to
301	nursing homes and how to obtain additional information regarding
302	these alternatives. The Nursing Home Guide shall explain that
303	this state offers alternative programs that permit qualified
304	elderly persons to stay in their homes instead of being placed
305	in nursing homes and shall encourage interested persons to call
306	the Comprehensive Assessment Review and Evaluation for Long-Term
307	Care Services (CARES) Program to inquire if they qualify. The
308	Nursing Home Guide shall list available home and community-based
309	programs which shall clearly state the services that are
310	provided and indicate whether nursing home services are included
311	if needed.
312	2.  A list by name and address of all nursing home
313	facilities in this state, including any prior name by which a
314	facility was known during the previous 24-month period.
315	3.  A list of all affiliated entities, controlling
316	entities, and controlling financial interests that are
317	affiliated with or associated with the licensee.
318	4.  Any documents related to audits, investigations, or
319	fines related to the receipt or use of federal or state funds by
320	the licensee or any affiliated entity, controlling entity, or
321	controlling financial interest, including all documents
322	submitted under s. 400.071.
323	5.3.  Whether such nursing home facilities are proprietary
324	or nonproprietary.
325	6.4.  The current owner of the facility's license and the
326	year that that entity became the owner of the license.
327	7.5.  The name of the owner or owners of each facility and
328	whether the facility is affiliated with a company or other
329	organization owning or managing more than one nursing facility
330	in this state.
331	8.6.  The total number of beds in each facility and the
332	most recently available occupancy levels.
333	9.7.  The number of private and semiprivate rooms in each
334	facility.
335	10.8.  The religious affiliation, if any, of each facility.
336	11.9.  The languages spoken by the administrator and staff
337	of each facility.
338	12.10.  Whether or not each facility accepts Medicare or
339	Medicaid recipients or insurance, health maintenance
340	organization, Veterans Administration, CHAMPUS program, or
341	workers' compensation coverage.
342	13.11.  Recreational and other programs available at each
343	facility.
344	14.12.  Special care units or programs offered at each
345	facility.
346	15.13.  Whether the facility is a part of a retirement
347	community that offers other services pursuant to part III of
348	this chapter or part I or part III of chapter 429.
349	16.14.  Survey and deficiency information, including all
350	federal and state recertification, licensure, revisit, and
351	complaint survey information, for each facility for the past 30
352	months. For noncertified nursing homes, state survey and
353	deficiency information, including licensure, revisit, and
354	complaint survey information for the past 30 months shall be
355	provided.
356	17.15.  A summary of the deficiency data for each facility
357	over the past 30 months. The summary may include a score,
358	rating, or comparison ranking with respect to other facilities
359	based on the number of citations received by the facility on
360	recertification, licensure, revisit, and complaint surveys; the
361	severity and scope of the citations; and the number of
362	recertification surveys the facility has had during the past 30
363	months. The score, rating, or comparison ranking may be
364	presented in either numeric or symbolic form for the intended
365	consumer audience.
366	18.  The name of the nursing home administrator and the
367	names of all members of the governing body, including their
368	dates of service.
369	19.  A list of nursing home facilities in the state, by
370	name and address, that have submitted applications for a change
371	of ownership, the date of the submission, and the current status
372	of the application. The agency shall update this list twice a
373	month.
374	(b)  The agency shall provide the following information in
375	printed form:
376	1.  A section entitled "Have you considered programs that
377	provide alternatives to nursing home care?" which shall be the
378	first section of the Nursing Home Guide and which shall
379	prominently display information about available alternatives to
380	nursing homes and how to obtain additional information regarding
381	these alternatives. The Nursing Home Guide shall explain that
382	this state offers alternative programs that permit qualified
383	elderly persons to stay in their homes instead of being placed
384	in nursing homes and shall encourage interested persons to call
385	the Comprehensive Assessment Review and Evaluation for Long-Term
386	Care Services (CARES) Program to inquire if they qualify. The
387	Nursing Home Guide shall list available home and community-based
388	programs which shall clearly state the services that are
389	provided and indicate whether nursing home services are included
390	if needed.
391	2.  A list by name and address of all nursing home
392	facilities in this state.
393	3.  Whether the nursing home facilities are proprietary or
394	nonproprietary.
395	4.  The current owner or owners of the facility's license
396	and the year that entity became the owner of the license.
397	5.  The total number of beds, and of private and
398	semiprivate rooms, in each facility.
399	6.  The religious affiliation, if any, of each facility.
400	7.  The name of the owner of each facility and whether the
401	facility is affiliated with a company or other organization
402	owning or managing more than one nursing facility in this state.
403	8.  The languages spoken by the administrator and staff of
404	each facility.
405	9.  Whether or not each facility accepts Medicare or
406	Medicaid recipients or insurance, health maintenance
407	organization, Veterans Administration, CHAMPUS program, or
408	workers' compensation coverage.
409	10.  Recreational programs, special care units, and other
410	programs available at each facility.
411	11.  The Internet address for the site where more detailed
412	information can be seen.
413	12.  A statement advising consumers that each facility will
414	have its own policies and procedures related to protecting
415	resident property.
416	13.  A summary of the deficiency data for each facility
417	over the past 30 months. The summary may include a score,
418	rating, or comparison ranking with respect to other facilities
419	based on the number of citations received by the facility on
420	recertification, licensure, revisit, and complaint surveys; the
421	severity and scope of the citations; the number of citations;
422	and the number of recertification surveys the facility has had
423	during the past 30 months. The score, rating, or comparison
424	ranking may be presented in either numeric or symbolic form for
425	the intended consumer audience.
426	(c)  The agency shall may provide the following additional
427	information on an Internet website site or in printed form as
428	the information becomes available:
429	1.  The licensure status history of each facility.
430	2.  The rating history of each facility.
431	3.  The regulatory history of each facility, which may
432	include federal sanctions, state sanctions, federal fines, state
433	fines, and other actions.
434	4.  Whether the facility currently possesses the Gold Seal
435	designation awarded pursuant to s. 400.235.
436	5.  Known Internet links to the Internet websites sites of
437	the facilities, or their affiliates, affiliated entities,
438	controlling entities, and controlling financial interests.
439	(5)  Every nursing home facility licensee shall:
440	(a)  Post, in a sufficient number of prominent locations
441	positions in the nursing home so as to be accessible to all
442	residents and to the general public:
443	1.  A concise summary of the last inspection report
444	pertaining to the nursing home and issued by the agency, with
445	references to the page numbers of the full reports, noting any
446	deficiencies found by the agency and the actions taken by the
447	licensee to rectify the deficiencies and indicating in the
448	summaries where the full reports may be inspected in the nursing
449	home.
450	2.  A copy of all of the pages that list the facility in
451	the most recent version of the Nursing Home Guide.
452	3.  A copy of the conditional license regardless of any
453	administrative challenge as a matter of public transparency and
454	timely notification.
455	(b)  Upon request, provide to any person who has completed
456	a written application with an intent to be admitted to, or to
457	any resident of, a nursing home, or to any relative, spouse, or
458	guardian of the person, a copy of the last inspection report
459	pertaining to the nursing home and issued by the agency,
460	provided the person requesting the report agrees to pay a
461	reasonable charge to cover copying costs.
462	Section 9.  Section 400.197, Florida Statutes, is created
463	to read:
464	400.197  Change of ownership of a facility.--
465	(1)  Within 5 days after a licensee submits a request for a
466	change of ownership of a facility to the agency, the licensee
467	shall notify all residents of a request for a change of
468	ownership in writing and post that information in a sufficient
469	number of prominent locations in the nursing home and on the
470	primary Internet website of the nursing home and its controlling
471	entities so that the information is accessible to all residents
472	and the general public.
473	(2)  Affected parties, including, but not limited to, a
474	resident, a resident's family member, a resident's legal
475	representative, a resident's guardian, and the staff of the
476	nursing facility may submit information for the agency to
477	consider when evaluating the applicant's character, experience,
478	background, qualifications, and fitness for licensure to
479	determine whether to grant a change of ownership.
480	(3)  The agency may propound any reasonable interrogatories
481	in addition to those contained in the application or make such
482	further investigation as it deems necessary or advisable for the
483	protection of the public and to ascertain the applicant's
484	character, experience, background, qualifications, and fitness
485	for the license.
486	(4)  When the agency grants a change of ownership, the new
487	licensee shall assume all the liabilities of the prior licensee,
488	affiliated entities of the prior licensee, and controlling
489	entities of the prior licensee.
490	Section 10.  Subsection (2) of section 419.001, Florida
491	Statutes, is amended to read:
492	419.001  Site selection of community residential homes.--
493	(2)  Homes of six or fewer residents which otherwise meet
494	the definition of a community residential home shall be deemed a
495	single-family unit and a noncommercial, residential use for the
496	purpose of local laws and ordinances. Homes of six or fewer
497	residents which otherwise meet the definition of a community
498	residential home shall be allowed in single-family or
499	multifamily zoning with without approval by the local
500	government, provided that such homes shall not be located within
501	a radius of 1,000 feet of another existing such home with six or
502	fewer residents and provided that the owner of the home resides
503	therein. Such homes with six or fewer residents shall not be
504	required to comply with the notification provisions of this
505	section; provided that, prior to licensure, the sponsoring
506	agency provides the local government with the most recently
507	published data compiled from the licensing entities that
508	identifies all community residential homes within the
509	jurisdictional limits of the local government in which the
510	proposed site is to be located in order to show that no other
511	community residential home is within a radius of 1,000 feet of
512	the proposed home with six or fewer residents. At the time of
513	home occupancy, the sponsoring agency must notify the local
514	government that the home is licensed by the licensing entity.
515	Section 11.  Present subsections (3) through (7) of section
516	429.02, Florida Statutes, are renumbered as subsections (4)
517	through (8), respectively, present subsections (8) through (10)
518	are renumbered as subsections (11) through (13), respectively,
519	present subsections (11) through (26) are renumbered as
520	subsections (15) through (30), respectively, present subsection
521	(11) is amended, and new subsections (3), (10), (11), and (14)
522	are added to that section to read:
523	429.02  Definitions.--When used in this part, the term:
524	(3)  "Affiliated entity" means any entity, entities, or
525	persons with the same or similar officers, board members,
526	directors, limited liability company members, operating company,
527	management company, or addresses.
528	(9)  "Controlling entity" means any entity, entities, or
529	persons that exhibit any indicia of control over the licensee or
530	applicant, including, but not limited to, control over resident
531	care, a facility's budget, or staffing levels; power over or
532	responsibility for employment decisions, capital purchases,
533	facility improvements, or plant improvements; access to or use
534	of the licensee's or applicant's assets or equipment; or
535	influence over the business decisions of the licensee or
536	applicant.
537	(10)  "Controlling financial interest" means any entity
538	that has a 5 percent or greater financial or ownership interest
539	in the licensee, an affiliated entity, or a controlling entity.
540	(14)  "Entity" means an individual, corporation,
541	partnership, association, joint venture, sole proprietorship,
542	limited liability company, professional limited liability
543	company, or any other manner and form of conducting business.
544	(15)(11)  "Extended congregate care" means acts beyond
545	those authorized in subsection (20) (16) that may be performed
546	pursuant to part I of chapter 464 by persons licensed thereunder
547	while carrying out their professional duties, and other
548	supportive services which may be specified by rule. The purpose
549	of such services is to enable residents to age in place in a
550	residential environment despite mental or physical limitations
551	that might otherwise disqualify them from residency in a
552	facility licensed under this part.
553	Section 12.  Subsections (1) and (2) of section 429.11,
554	Florida Statutes, are amended, and subsection (8) is added to
555	that section, to read:
556	429.11  Initial application for license; provisional
557	license.--
558	(1)  Each applicant for licensure must comply with all
559	provisions of part II of chapter 408 and must:
560	(a)  Identify all other homes or facilities, including the
561	addresses and the license or licenses under which they operate,
562	if applicable, which are currently operated by the applicant or
563	administrator and which provide housing, meals, and personal
564	services to residents.
565	(b)  Submit a signed affidavit disclosing any affiliated
566	entities, controlling entities, and controlling financial
567	interests of the licensee.
568	(c)  Provide copies of any contracts with affiliated
569	entities or controlling entities, including details of goods and
570	services provided and the intended method of payment for those
571	goods and services.
572	(d)  Provide copies of any audits, investigations, or fines
573	related to the receipt or use of federal or state funds by all
574	affiliated entities, controlling entities, and controlling
575	financial interests, including the results of or documentation
576	pertaining to any ongoing investigation into Medicaid or
577	Medicare fraud or overpayment, any standing corporate integrity
578	agreements, or other remedial action by any public entity.
579	(e)(b)  Provide the location of the facility for which a
580	license is sought and documentation, signed by the appropriate
581	local government official, which states that the applicant has
582	met local zoning requirements.
583	(f)(c)  Provide the name, address, date of birth, social
584	security number, education, and experience of the administrator,
585	if different from the applicant.
586	(2)  The applicant shall provide proof of liability
587	insurance as defined in s. 624.605. The required general and
588	professional liability insurance may not be used for litigation
589	costs or attorney's fees for the defense of any claim against an
590	assisted living facility pursuant to the common law, s. 429.29,
591	or s. 429.293.
592	(8)  As a condition of licensure, relicensure, or change of
593	ownership, the licensee shall provide to the agency a signed
594	affidavit disclosing any financial or ownership interest that an
595	affiliated entity, controlling entity, or controlling financial
596	interest acquires within 30 days after the acquisition.
597	Section 13.  Section 429.12, Florida Statutes, is amended
598	to read:
599	429.12  Sale or transfer of ownership of a facility.--It is
600	the intent of the Legislature to protect the rights of the
601	residents of an assisted living facility when the facility is
602	sold or the ownership thereof is transferred. Therefore, in
603	addition to the requirements of part II of chapter 408:,
604	(1)  Within 5 days after a licensee submits a request for a
605	change of ownership of a facility to the agency, the licensee
606	shall notify all residents of the request in writing and post
607	that information in a sufficient number of prominent locations
608	in the assisted living facility and on the primary Internet
609	website of the facility and its controlling entities so that the
610	information is accessible to all residents and the general
611	public.
612	(2)  Affected parties, including, but not limited to, a
613	resident, a resident's family member, a resident's legal
614	representative, a resident's guardian, and the staff of the
615	assisted living facility may submit information for the agency
616	to consider in evaluating the applicant's character, experience,
617	background, qualifications, and fitness for the license when
618	determining whether to grant a change of ownership.
619	(3)  The agency may propound any reasonable interrogatories
620	in addition to those contained in the application or make such
621	further investigation as it may deem necessary or advisable for
622	the protection of the public and to ascertain the applicant's
623	character, experience, background, qualifications, and fitness
624	for the license.
625	(4)  When the agency grants a change of ownership, the new
626	licensee shall assume all liabilities of a prior licensee, an
627	affiliated entity of the prior licensee, and a controlling
628	entity of the prior licensee.
629	(5)  Whenever a facility is sold or the ownership thereof
630	is transferred, including leasing:
631	(a)(1)  The transferee shall notify the residents, in
632	writing, of the change of ownership within 7 days after receipt
633	of the new license.
634	(b)(2)  The transferor of a facility the license of which
635	is denied pending an administrative hearing shall, as a part of
636	the written change-of-ownership contract, advise the transferee
637	that a plan of correction must be submitted by the transferee
638	and approved by the agency at least 7 days before the change of
639	ownership and that failure to correct the condition which
640	resulted in the moratorium pursuant to part II of chapter 408 or
641	denial of licensure is grounds for denial of the transferee's
642	license.
643	Section 14.  Paragraph (m) is added to subsection (1) of
644	section 429.14, Florida Statutes, and subsections (3) and (7) of
645	that section, are amended to read:
646	429.14  Administrative penalties.--
647	(1)  In addition to the requirements of part II of chapter
648	408, the agency may deny, revoke, and suspend any license issued
649	under this part and impose an administrative fine in the manner
650	provided in chapter 120 against a licensee of an assisted living
651	facility for a violation of any provision of this part, part II
652	of chapter 408, or applicable rules, or for any of the following
653	actions by a licensee of an assisted living facility, for the
654	actions of any person subject to level 2 background screening
655	under s. 408.809, or for the actions of any facility employee:
656	(m)  Failure to disclose at the time of licensure,
657	relicensure, or change of ownership all affiliated entities,
658	controlling entities, and controlling financial interests.
659	(3)  The agency may deny a license to any applicant or
660	controlling interest as defined in part II of chapter 408 which
661	has or had a 25-percent or greater financial or ownership
662	interest in any other facility licensed under this part, in any
663	affiliated entity or controlling entity, or in any entity
664	licensed by this state or another state to provide health or
665	residential care, which facility or entity during the 5 years
666	prior to the application for a license closed due to financial
667	inability to operate; had a receiver appointed or a license
668	denied, suspended, or revoked; was subject to a moratorium; or
669	had an injunctive proceeding initiated against it.
670	(7)  Agency notification of a license suspension or
671	revocation, or denial of a license renewal, or issuance of a
672	conditional license, regardless of any administrative challenge,
673	shall be posted and visible to the public at the facility.
674	Section 15.  Section 429.174, Florida Statutes, is amended
675	to read:
676	429.174  Background screening; exemptions.--The owner or
677	administrator of an assisted living facility must conduct level
678	1 background screening, as set forth in chapter 435, on all
679	employees hired on or after October 1, 1998, who perform
680	personal services as defined in s. 429.02(20)(16). The agency
681	may exempt an individual from employment disqualification as set
682	forth in chapter 435. Such persons shall be considered as having
683	met this requirement if:
684	(1)  Proof of compliance with level 1 screening
685	requirements obtained to meet any professional license
686	requirements in this state is provided and accompanied, under
687	penalty of perjury, by a copy of the person's current
688	professional license and an affidavit of current compliance with
689	the background screening requirements.
690	(2)  The person required to be screened has been
691	continuously employed in the same type of occupation for which
692	the person is seeking employment without a breach in service
693	which exceeds 180 days, and proof of compliance with the level 1
694	screening requirement which is no more than 2 years old is
695	provided. Proof of compliance shall be provided directly from
696	one employer or contractor to another, and not from the person
697	screened. Upon request, a copy of screening results shall be
698	provided by the employer retaining documentation of the
699	screening to the person screened.
700	(3)  The person required to be screened is employed by a
701	corporation or business entity or related corporation or
702	business entity that owns, operates, or manages more than one
703	facility or agency licensed under this chapter, and for whom a
704	level 1 screening was conducted by the corporation or business
705	entity as a condition of initial or continued employment.
706	Section 16.  Subsection (3) of section 429.275, Florida
707	Statutes, is amended to read:
708	429.275  Business practice; personnel records; liability
709	insurance.--The assisted living facility shall be administered
710	on a sound financial basis that is consistent with good business
711	practices.
712	(3)  The administrator or owner of a facility shall
713	maintain liability insurance coverage that is in force at all
714	times. The required general and professional liability insurance
715	shall not be used for litigation costs or attorney's fees for
716	the defense of any claim against an assisted living facility
717	pursuant to the common law, s. 429.29, or s. 429.293. The
718	administrator or owner of a facility shall notify the agency
719	immediately when the policy limits have been exhausted.
720	Section 17.  This act shall take effect July 1, 2008.

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