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Senator Jones moved the following amendment:

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     Senate Amendment (with title amendment)

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     Delete line(s) 725-854

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and insert:

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     (c) A home health agency that is not Medicare or Medicaid

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certified and does not provide skilled care or provides only

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physical, occupational, or speech therapy is not required to have

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a director of nursing and is exempt from paragraph (b).

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     (3) TRAINING.--A home health agency shall ensure that each

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certified nursing assistant employed by or under contract with

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the home health agency and each home health aide employed by or

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under contract with the home health agency is adequately trained

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to perform the tasks of a home health aide in the home setting.

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     (4) STAFFING.--Staffing services may be provided anywhere

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within the state.

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     Section 6.  Section 400.484, Florida Statutes, is amended to

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read:

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     400.484  Right of inspection; deficiencies; fines.--

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     (1)  In addition to the requirements of s. 408.811, the

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agency may make such inspections and investigations as are

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necessary in order to determine the state of compliance with this

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part, part II of chapter 408, and applicable rules.

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     (2)  The agency shall impose fines for various classes of

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deficiencies in accordance with the following schedule:

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     (a)  A class I deficiency is any act, omission, or practice

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that results in a patient's death, disablement, or permanent

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injury, or places a patient at imminent risk of death,

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disablement, or permanent injury. Upon finding a class I

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deficiency, the agency shall may impose an administrative fine in

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the amount of $15,000 $5,000 for each occurrence and each day

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that the deficiency exists.

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     (b)  A class II deficiency is any act, omission, or practice

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that has a direct adverse effect on the health, safety, or

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security of a patient. Upon finding a class II deficiency, the

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agency shall may impose an administrative fine in the amount of

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$5,000 $1,000 for each occurrence and each day that the

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deficiency exists.

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     (c)  A class III deficiency is any act, omission, or

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practice that has an indirect, adverse effect on the health,

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safety, or security of a patient. Upon finding an uncorrected or

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repeated class III deficiency, the agency shall may impose an

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administrative fine not to exceed $1,000 $500 for each occurrence

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and each day that the uncorrected or repeated deficiency exists.

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     (d)  A class IV deficiency is any act, omission, or practice

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related to required reports, forms, or documents which does not

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have the potential of negatively affecting patients. These

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violations are of a type that the agency determines do not

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threaten the health, safety, or security of patients. Upon

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finding an uncorrected or repeated class IV deficiency, the

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agency shall may impose an administrative fine not to exceed $500

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$200 for each occurrence and each day that the uncorrected or

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repeated deficiency exists.

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     (3)  In addition to any other penalties imposed pursuant to

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this section or part, the agency may assess costs related to an

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investigation that results in a successful prosecution, excluding

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costs associated with an attorney's time.

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================ T I T L E  A M E N D M E N T ================

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And the title is amended as follows:

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     Delete line(s) 54-69

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and insert:

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staffing requirements for a director of nursing; providing

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for fines; exempting a home health agency that is not

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Medicare or Medicaid certified and does not provide

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skilled care or provides only physical, occupational, or

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speech therapy from requirements related to a director of

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nursing; providing training requirements for certified

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nursing assistants and home health aides; amending s.

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400.484, F.S.; requiring the agency to impose

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administrative fines for certain deficiencies; increasing

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the administrative fines imposed for certain deficiencies;

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amending s. 400.491,

4/22/2008  9:23:00 AM     13-08204-08