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The Committee on Children, Families, and Elder Affairs (Storms)

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recommended the following amendment:

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     Senate Amendment (with title amendment)

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     Delete everything after the enacting clause

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and insert:

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     Section 1.  Subsection (4) of section 322.142, Florida

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Statutes, is amended to read:

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     322.142  Color photographic or digital imaged licenses.--

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     (4)  The department may maintain a film negative or print

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file. The department shall maintain a record of the digital

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image and signature of the licensees, together with other data

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required by the department for identification and retrieval.

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Reproductions from the file or digital record are exempt from

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the provisions of s. 119.07(1) and shall be made and issued only

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for departmental administrative purposes; for the issuance of

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duplicate licenses; in response to law enforcement agency

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requests; to the Department of State pursuant to an interagency

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agreement to facilitate determinations of eligibility of voter

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registration applicants and registered voters in accordance with

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ss. 98.045 and 98.075; to the Department of Revenue pursuant to

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an interagency agreement for use in establishing paternity and

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establishing, modifying, or enforcing support obligations in

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Title IV-D cases; to the Department of Children and Family

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Services pursuant to an interagency agreement to conduct

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protective investigations under chapter 415; or to the

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Department of Financial Services pursuant to an interagency

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agreement to facilitate the location of owners of unclaimed

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property, the validation of unclaimed property claims, and the

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identification of fraudulent or false claims, and are exempt

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from the provisions of s. 119.07(1).

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     Section 2.  Subsection (25) is added to section 400.141,

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Florida Statutes, to read:

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     400.141  Administration and management of nursing home

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facilities.--Every licensed facility shall comply with all

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applicable standards and rules of the agency and shall:

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     (25) Conduct a level 1 background screening as defined in

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chapter 435, of a prospective resident before admission or

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immediately after admission at the resident's expense. The

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information obtained may be used by the facility to assess the

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needs of the resident and to provide adequate and appropriate

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health care and protective and support services in accordance

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with this part. The Agency's employee background screening

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database may not be used for resident screening. If a resident

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transfers between facilities, the resident's background

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screening results shall be transferred with the resident.

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Facilities that have been awarded a Gold Seal under the program

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established in s. 400.235 may develop a plan to provide

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certified nursing assistant training as prescribed by federal

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regulations and state rules and may apply to the agency for

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approval of their program.

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     Section 3.  Subsection (3) of section 400.19, Florida

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Statutes, is amended to read:

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     400.19  Right of entry and inspection.--

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     (3)  The agency shall every 15 months conduct at least one

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unannounced inspection to determine compliance by the licensee

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with statutes, and related with rules promulgated under the

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provisions of those statutes, governing minimum standards of

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construction, quality and adequacy of care, and rights of

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residents. The survey shall be conducted every 6 months for the

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next 2-year period if the facility has been cited for a class I

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deficiency, has been cited for two or more class II deficiencies

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arising from separate surveys or investigations within a 60-day

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period, or has had three or more substantiated complaints within

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a 6-month period, each resulting in at least one class I or

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class II deficiency. In addition to any other fees or fines in

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this part, the agency shall assess a fine for each facility that

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is subject to the 6-month survey cycle. The fine for the 2-year

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period shall be $6,000, one-half to be paid at the completion of

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each survey. The agency may adjust this fine by the change in

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the Consumer Price Index, based on the 12 months immediately

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preceding the change increase, to cover the cost of the

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additional surveys. The agency shall verify through subsequent

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inspection that any deficiency identified during inspection is

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corrected. However, the agency may verify the correction of a

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class III or class IV deficiency unrelated to resident rights or

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resident care without reinspecting the facility if adequate

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written documentation has been received from the facility, which

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provides assurance that the deficiency has been corrected. The

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giving or causing to be given of advance notice of such

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unannounced inspections by an employee of the agency to any

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unauthorized person shall constitute cause for suspension of not

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fewer than 5 working days according to the provisions of chapter

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110.

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     Section 4.  Section 400.215, Florida Statutes, is amended

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to read:

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     400.215 Background Personnel screening requirement.--

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     (1) The agency shall require Background screening as

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provided in chapter 435 is required for all nursing home

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facility employees and contracted workers or prospective

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employees of facilities licensed under this part who are

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expected to, or whose responsibilities may require them to:

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     (a)  Provide personal care or services to residents;

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     (b)  Have access to resident living areas; or

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     (c)  Have access to resident funds or other personal

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property.

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     (2) Employers, and employees, contractors, and contracted

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workers shall comply with the requirements of s. 435.05.

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     (a) Notwithstanding the provisions of s. 435.05(1),

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facilities must have in their possession evidence that level 1

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screening under s. 435.03 has been completed before allowing an

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employee or contracted worker to begin employment in the

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facility working with patients as provided in subsection (1).

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All information necessary for conducting level 1 background

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screening using level 1 standards as specified in s. 435.03

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shall be submitted by the nursing facility to the agency.

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Results of the background screening shall be provided by the

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agency to the requesting nursing facility.

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     (b) Employees and contracted workers qualified under the

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provisions of paragraph (a) who have not maintained continuous

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residency within the state for the 5 years immediately preceding

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the date of request for background screening must complete level

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2 screening, as provided in s. 435.04 chapter 435. Such

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Employees may work in a conditional status for up to 180 days

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pending the receipt of written findings evidencing the

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completion of level 2 screening. Contracted workers who are

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awaiting the completion of level 2 screening may work only under

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the direct and visual supervision of persons who have met the

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screening requirements of this section. Level 2 screening is

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shall not be required for of employees, or prospective

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employees, or contracted workers who attest in writing under

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penalty of perjury that they meet the residency requirement. To

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complete Completion of level 2 screening: shall require

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     1. The employee or contracted worker shall prospective

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employee to furnish to the nursing facility a full set of

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fingerprints for conducting a federal criminal records check to

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enable a criminal background investigation to be conducted.

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     2. The nursing facility shall submit the completed

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fingerprint card to the agency.

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     3. The agency shall establish a record of the request in

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the database provided for in paragraph (c) and forward the

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request to the Department of Law Enforcement, which is

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authorized to submit the fingerprints to the Federal Bureau of

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Investigation for a national criminal history records check.

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     4. The results of the national criminal history records

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check shall be returned to the agency, which shall maintain the

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results in the database provided for in paragraph (c).

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     5. The agency shall notify the administrator of the

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requesting nursing facility or the administrator of any other

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requesting facility licensed under chapter 393, chapter 394,

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chapter 395, chapter 397, chapter 429, or this chapter, as

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requested by such facility, as to whether or not the employee

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has qualified under level 1 or level 2 screening.

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An employee or contracted worker prospective employee who has

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qualified under level 2 screening and has maintained such

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continuous residency within the state is shall not be required

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to complete a subsequent level 2 screening as a condition of

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employment at another facility.

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A contract worker who is retained on an emergency basis or for a

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task involving repair or maintenance that will require the

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contract worker to be on the premises for less than one day,

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shall not be required to have a background screen under this

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section, but must be required to sign in upon entering the

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building, wear an identification badge, and sign out before

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leaving the building. The facility shall maintain a log with the

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information collected.

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     (c)  The agency shall establish and maintain a database

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that includes of background screening information which shall

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include the results of all both level 1 and level 2 screening.

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The Department of Law Enforcement shall timely provide to the

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agency, electronically, the results of each statewide screening

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for incorporation into the database. The agency shall, upon

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request from any facility, agency, or program required by or

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authorized by law to screen its employees or contracted workers

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applicants, notify the administrator of the facility, agency, or

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program of the qualifying or disqualifying status of the person

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employee or applicant named in the request.

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     (d) Applicants and Employees, prospective employees, and

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contracted workers shall be excluded from employment pursuant to

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s. 435.06, and may not be employed or resume employment until

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exempted or all appeals have been resolved in favor of the

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person screened.

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     (3) The person being screened applicant is responsible for

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paying the fees associated with obtaining the required

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screening. Payment for the screening shall be submitted to the

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agency. The agency shall establish a schedule of fees to cover

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the costs of level 1 and level 2 screening. Facilities may pay

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reimburse employees for these costs. The Department of Law

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Enforcement shall charge the agency for a level 1 or level 2

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screening a rate sufficient to cover the costs of such screening

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pursuant to s. 943.053(3). The agency shall, as allowable,

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reimburse nursing facilities for the cost of conducting

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background screening as required by this section. This

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reimbursement is will not be subject to any rate ceilings or

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payment targets in the Medicaid Reimbursement plan.

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     (4)(a) As provided in s. 435.07:,

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     (a) The agency may grant an exemption from

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disqualification to an employee, or prospective employee, or

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contracted worker who is subject to this section and who has not

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received a professional license or certification from the

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Department of Health.

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     (b) As provided in s. 435.07, The appropriate regulatory

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board within the Department of Health, or that department itself

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when there is no board, may grant an exemption from

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disqualification to an employee, or prospective employee, or

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contracted worker who is subject to this section and who has

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received a professional license or certification from the

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Department of Health or a regulatory board within that

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department.

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     (5) Any provision of law to the contrary notwithstanding,

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Persons who have been screened and qualified as required by this

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section, and who have not been unemployed for more than 180 days

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thereafter, and who, under penalty of perjury, attest to not

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having been convicted of a disqualifying offense since the

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completion of such screening are, shall not be required to be

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rescreened. An employer may obtain, pursuant to s. 435.10,

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written verification of qualifying screening results from the

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previous employer, contractor, or other entity that which caused

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the such screening to be performed.

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     (6) The agency and the Department of Health may shall have

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authority to adopt rules to administer pursuant to the

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Administrative Procedure Act to implement this section.

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     (7) All employees shall comply with the requirements of

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this section by October 1, 1998. No current employee of a

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nursing facility as of the effective date of this act shall be

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required to submit to rescreening if the nursing facility has in

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its possession written evidence that the person has been

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screened and qualified according to level 1 standards as

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specified in s. 435.03(1). Any current employee who meets the

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level 1 requirement but does not meet the 5-year residency

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requirement as specified in this section must provide to the

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employing nursing facility written attestation under penalty of

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perjury that the employee has not been convicted of a

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disqualifying offense in another state or jurisdiction. All

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applicants hired on or after October 1, 1998, shall comply with

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the requirements of this section.

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     (7)(8) There is no monetary or unemployment liability on

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the part of, and a no cause of action for damages does not arise

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arising against, an employer that, upon notice of a

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disqualifying offense listed under chapter 435 or an act of

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domestic violence, terminates the employee against whom the

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report was issued, whether or not the employee has filed for an

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exemption with the Department of Health or the agency for Health

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Care Administration.

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     Section 5.  Subsection (6) of section 408.809, Florida

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Statutes, is created to read:

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     408.809  Background screening; prohibited offenses.--

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     (6) The agency shall establish a schedule of fees to cover

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the costs of any Level 1 or Level 2 screening required pursuant

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to this part or other authorizing statutes and may adopt rules

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to carryout these screenings and for the schedule of fees.

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     Section 6.  Subsection (5) of section 408.810, Florida

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Statutes, is amended to read:

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     408.810  Minimum licensure requirements.--In addition to

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the licensure requirements specified in this part, authorizing

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statutes, and applicable rules, each applicant and licensee must

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comply with the requirements of this section in order to obtain

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and maintain a license.

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     (5) Each licensee must:

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     (a)  On or before the first day services are provided to a

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client, a licensee must inform the client and his or her

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immediate family or representative, if appropriate, of the right

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to report:

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     1.  Complaints. The statewide toll-free telephone number

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for reporting complaints to the agency must be provided to

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clients in a manner that is clearly legible and must include the

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words: "To report a complaint regarding the services you

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receive, please call toll-free (phone number)."

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     2.  Abusive, neglectful, or exploitative practices. The

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statewide toll-free telephone number for the central abuse

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hotline must be provided to clients in a manner that is clearly

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legible and must include the words: "To report abuse, neglect,

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or exploitation, please call toll-free (phone number)." The

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agency shall publish a minimum of a 90-day advance notice of a

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change in the toll-free telephone numbers.

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     (b) Each licensee shall Establish appropriate policies and

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procedures for providing such notice to clients.

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     (c) Publicly display a poster approved by the agency

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containing the names, addresses, and telephone numbers for the

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state's central abuse hotline, the State Long-Term Care

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Ombudsman, the agency's consumer hotline, the Advocacy Center

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for Persons with Disabilities, the Florida Statewide Advocacy

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Council, the Medicaid Fraud Control Unit, and the Statewide

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Public Guardianship Office, along with a clear description of

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the assistance to be expected from each. The agency may charge a

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fee for the cost of production and distribution of the poster.

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     Section 7.  Paragraph (a) is amended and paragraphs (c) and

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(d) are created in subsection (1) and paragraph (c) is created

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in subsection (4) of section 408.811, Florida Statutes, to read:

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     408.811  Right of inspection; copies; inspection reports.--

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     (1)  An authorized officer or employee of the agency may

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make or cause to be made any inspection or investigation deemed

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necessary by the agency to determine the state of compliance

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with this part, authorizing statutes, and applicable rules. The

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right of inspection extends to any business that the agency has

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reason to believe is being operated as a provider without a

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license, but inspection of any business suspected of being

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operated without the appropriate license may not be made without

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the permission of the owner or person in charge unless a warrant

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is first obtained from a circuit court. Any application for a

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license issued under this part, authorizing statutes, or

296

applicable rules constitutes permission for an appropriate

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inspection to verify the information submitted on or in

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connection with the application.

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     (a)  All inspections shall be unannounced, except as

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specified in s. 408.806. The giving or causing to be given of

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advance notice of the unannounced inspection by an agency

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employee to any unauthorized person shall, in accordance with

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chapter 110, constitute cause for suspension of the employee for

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at least 5 working days.

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     (b)  Inspections for relicensure shall be conducted

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biennially unless otherwise specified by authorizing statutes or

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applicable rules.

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     (c) Deficiencies found during an inspection or

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investigation must be corrected within 30 days unless an

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alternative timeframe is required or approved by the agency.

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     (d) The agency may require an applicant or licensee to

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submit a plan of correction for deficiencies. If required, the

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plan of correction must be filed with the agency within ten days

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unless an alternative timeframe is required.

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     (2)  Inspections conducted in conjunction with

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certification may be accepted in lieu of a complete licensure

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inspection. However, a licensure inspection may also be

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conducted to review any licensure requirements that are not also

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requirements for certification.

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     (3)  The agency shall have access to and the licensee shall

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provide copies of all provider records required during an

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inspection at no cost to the agency.

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     (4)(a)  Each licensee shall maintain as public information,

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available upon request, records of all inspection reports

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pertaining to that provider that have been filed by the agency

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unless those reports are exempt from or contain information that

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is exempt from s. 119.07(1) and s. 24(a), Art. I of the State

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Constitution or is otherwise made confidential by law. Effective

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October 1, 2006, copies of such reports shall be retained in the

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records of the provider for at least 3 years following the date

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the reports are filed and issued, regardless of a change of

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ownership.

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     (b)  A licensee shall, upon the request of any person who

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has completed a written application with intent to be admitted

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by such provider, any person who is a client of such provider,

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or any relative, spouse, or guardian of any such person, furnish

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to the requester a copy of the last inspection report pertaining

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to the licensed provider that was issued by the agency or by an

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accrediting organization if such report is used in lieu of a

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licensure inspection.

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     (c) As an alternative to sending reports required by this

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part or authorizing statutes, the agency may provide electronic

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access to information or documents.

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     Section 8.  Subsection (2) of section 415.103, Florida

345

Statutes, is amended to read:

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     415.103  Central abuse hotline.--

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     (2)  Upon receiving an oral or written report of known or

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suspected abuse, neglect, or exploitation of a vulnerable adult,

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the central abuse hotline shall must determine if the report

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requires an immediate onsite protective investigation.

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     (a) For reports requiring an immediate onsite protective

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investigation, the central abuse hotline must immediately notify

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the department's designated protective investigative district

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staff responsible for protective investigations to ensure prompt

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initiation of an onsite investigation.

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     (b) For reports not requiring an immediate onsite

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protective investigation, the central abuse hotline must notify

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the department's designated protective investigative district

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staff responsible for protective investigations in sufficient

360

time to allow for an investigation to be commenced within 24

361

hours. At the time of notification of district staff with

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respect to the report, the central abuse hotline must also

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provide any known information on any previous reports report

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concerning the a subject of the present report or any pertinent

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information relative to the present report or any noted earlier

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reports.

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     (c) If the report is of known or suspected abuse of a

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vulnerable adult by someone other than a relative, caregiver, or

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household member, the call shall be immediately transferred to

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the appropriate county sheriff's office.

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     Section 9.  Paragraph (e) of subsection (1) and paragraph

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(g) of subsection (2) of section 415.1051, Florida Statutes, are

373

amended to read:

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     415.1051  Protective services interventions when capacity

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to consent is lacking; nonemergencies; emergencies; orders;

376

limitations.--

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     (1)  NONEMERGENCY PROTECTIVE SERVICES INTERVENTIONS.--If

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the department has reasonable cause to believe that a vulnerable

379

adult or a vulnerable adult in need of services is being abused,

380

neglected, or exploited and is in need of protective services

381

but lacks the capacity to consent to protective services, the

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department shall petition the court for an order authorizing the

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provision of protective services.

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     (e)  Continued protective services.--

385

     1. Within No more than 60 days after the date of the order

386

authorizing the provision of protective services, the department

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shall petition the court to determine whether:

388

     a. Protective services are to will be continued with the

389

consent of the vulnerable adult pursuant to this subsection;

390

     b. Protective services are to will be continued for the

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vulnerable adult who lacks capacity;

392

     c. Protective services are to will be discontinued; or

393

     d. A petition for guardianship shall should be filed

394

pursuant to chapter 744.

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     2.  If the court determines that a petition for

396

guardianship shall should be filed pursuant to chapter 744, the

397

court, for good cause shown, may order continued protective

398

services until it makes a determination regarding capacity.

399

     3. If the department has a good faith belief that the

400

vulnerable adult lacks capacity, the petition to determine

401

incapacity under s. 744.3201 may be filed by the department.

402

Once the petition is filed, the department may not be appointed

403

guardian and may not provide legal counsel for the guardian.

404

     (2)  EMERGENCY PROTECTIVE SERVICES INTERVENTION.--If the

405

department has reasonable cause to believe that a vulnerable

406

adult is suffering from abuse or neglect that presents a risk of

407

death or serious physical injury to the vulnerable adult and

408

that the vulnerable adult lacks the capacity to consent to

409

emergency protective services, the department may take action

410

under this subsection. If the vulnerable adult has the capacity

411

to consent and refuses consent to emergency protective services,

412

emergency protective services may not be provided.

413

     (g)  Continued emergency protective services.--

414

     1. Within Not more than 60 days after the date of the

415

order authorizing the provision of emergency protective

416

services, the department shall petition the court to determine

417

whether:

418

     a. Emergency protective services are to will be continued

419

with the consent of the vulnerable adult;

420

     b. Emergency protective services are to will be continued

421

for the vulnerable adult who lacks capacity;

422

     c. Emergency protective services are to will be

423

discontinued; or

424

     d. A petition shall should be filed under chapter 744.

425

     2.  If it is decided to file a petition under chapter 744,

426

for good cause shown, the court may order continued emergency

427

protective services until a determination is made by the court.

428

     3. If the department has a good faith belief that the

429

vulnerable adult lacks capacity, the petition to determine

430

incapacity under s. 744.3201 may be filed by the department.

431

Once the petition is filed, the department may not be appointed

432

guardian and may not provide legal counsel for the guardian.

433

     Section 10.  Section 415.112, Florida Statutes, is amended

434

to read:

435

     415.112 Rules for implementation of ss. 415.101-

436

415.113.--The department shall adopt promulgate rules to

437

administer this chapter including, but not limited to: for the

438

implementation of ss. 415.101-415.113.

439

     (1) Background screening of department employees and

440

employee applicants which includes a criminal records check and

441

drug testing of adult protective investigators and adult

442

protective investigator supervisors.

443

     (2) The reporting of adult abuse, neglect, exploitation, a

444

vulnerable adult in need of services, false reporting, and adult

445

protective investigations.

446

     (3) Confidentiality and retention of department records,

447

access to records, and record requests.

448

     (4) Injunctions and other protective orders.

449

     (5) The provision of emergency and nonemergency protective

450

services intervention.

451

     (6) Agreements with law enforcement and other state

452

agencies.

453

     (7) Legal and casework procedures, including, but not

454

limited to, diligent search, petitions, emergency removals,

455

capacity to consent, and adult protection teams.

456

     (8) The legal and casework management of cases involving

457

protective supervision, protective orders, judicial reviews,

458

administrative reviews, case plans, and documentation

459

requirements.

460

     Section 11.  Subsection (21) of section 429.02, Florida

461

Statutes, is amended to read:

462

     429.02  Definitions.--When used in this part, the term:

463

     (21)  "Service plan" means a written plan, developed and

464

agreed upon by the resident and, if applicable, the resident's

465

representative or designee or the resident's surrogate,

466

guardian, or attorney in fact, if any, and the administrator or

467

designee representing the facility, which addresses the unique

468

physical and psychosocial needs, abilities, and personal

469

preferences of each resident receiving extended congregate care

470

services. The plan must shall include a brief written

471

description, in easily understood language, of what services

472

shall be provided, who shall provide the services, when the

473

services shall be rendered, and the purposes and benefits of the

474

services. The agency shall develop a service plan form for use

475

by providers.

476

     Section 12.  Paragraphs (b) and (c) of subsection (3) of

477

section 429.07, Florida Statutes, are amended to read:

478

     429.07  License required; fee.--

479

     (3)  In addition to the requirements of s. 408.806, each

480

license granted by the agency must state the type of care for

481

which the license is granted. Licenses shall be issued for one

482

or more of the following categories of care: standard, extended

483

congregate care, limited nursing services, or limited mental

484

health.

485

     (b)  An extended congregate care license shall be issued to

486

facilities providing, directly or through contract, services

487

beyond those authorized in paragraph (a), including services

488

performed by persons licensed under acts performed pursuant to

489

part I of chapter 464 by persons licensed thereunder, and

490

supportive services, as defined by rule, to persons who would

491

otherwise would be disqualified from continued residence in a

492

facility licensed under this part.

493

     1. To obtain an In order for extended congregate care

494

license services to be provided in a facility licensed under

495

this part, the agency must first determine that all requirements

496

established in law and rule are met and must specifically

497

designate, on the facility's license, that such services may be

498

provided and whether the designation applies to all or part of

499

the a facility. Such designation may be made at the time of

500

initial licensure or relicensure, or upon request in writing by

501

a licensee under this part and part II of chapter 408.

502

Notification of approval or denial of the such request shall be

503

made in accordance with part II of chapter 408. Existing

504

     2. Facilities applying for, and facilities currently

505

licensed qualifying to provide, extended congregate care

506

services must have maintained a standard license and may not

507

have been subject to administrative sanctions during the

508

previous 2 years, or since initial licensure if the facility has

509

been licensed for less than 2 years, for any of the following

510

reasons:

511

     a.  A class I or class II violation;

512

     b.  Three or more repeat or recurring class III violations

513

of identical or similar resident care standards as specified in

514

rule from which a pattern of noncompliance is found by the

515

agency;

516

     c.  Three or more class III violations that were not

517

corrected in accordance with the corrective action plan approved

518

by the agency;

519

     d. Violation of resident care standards which result in

520

requiring the facility resulting in a requirement to employ the

521

services of a consultant pharmacist or consultant dietitian;

522

     e.  Denial, suspension, or revocation of a license for

523

another facility licensed under this part in which the applicant

524

for an extended congregate care license has at least 25 percent

525

ownership interest; or

526

     f.  Imposition of a moratorium pursuant to this part or

527

part II of chapter 408 or initiation of injunctive proceedings.

528

     3.2. A facility that is Facilities that are licensed to

529

provide extended congregate care services must shall maintain a

530

written progress report on each person who receives such

531

services, which report describes the type, amount, duration,

532

scope, and outcome of services that are rendered and the general

533

status of the resident's health. A registered nurse, or

534

appropriate designee, representing the agency shall visit the

535

facility such facilities at least quarterly to monitor residents

536

who are receiving extended congregate care services and to

537

determine if the facility is in compliance with this part, part

538

II of chapter 408, and rules that relate to extended congregate

539

care. One of these visits may be in conjunction with the regular

540

survey. The monitoring visits may be provided through

541

contractual arrangements with appropriate community agencies. A

542

registered nurse shall serve as part of the team that inspects

543

the such facility. The agency may waive one of the required

544

yearly monitoring visits for a facility that has been licensed

545

for at least 24 months to provide extended congregate care

546

services, if, during the inspection, the registered nurse

547

determines that extended congregate care services are being

548

provided appropriately, and if the facility has no class I or

549

class II violations and no uncorrected class III violations.

550

Before such decision is made, The agency must first shall

551

consult with the long-term care ombudsman council for the area

552

in which the facility is located to determine if any complaints

553

have been made and substantiated about the quality of services

554

or care. The agency may not waive one of the required yearly

555

monitoring visits if complaints have been made and

556

substantiated.

557

     4.3. Facilities that are licensed to provide extended

558

congregate care services must shall:

559

     a.  Demonstrate the capability to meet unanticipated

560

resident service needs.

561

     b.  Offer a physical environment that promotes a homelike

562

setting, provides for resident privacy, promotes resident

563

independence, and allows sufficient congregate space as defined

564

by rule.

565

     c.  Have sufficient staff available, taking into account

566

the physical plant and firesafety features of the building, to

567

assist with the evacuation of residents in an emergency, as

568

necessary.

569

     d.  Adopt and follow policies and procedures that maximize

570

resident independence, dignity, choice, and decisionmaking to

571

permit residents to age in place to the extent possible, so that

572

moves due to changes in functional status are minimized or

573

avoided.

574

     e.  Allow residents or, if applicable, a resident's

575

representative, designee, surrogate, guardian, or attorney in

576

fact to make a variety of personal choices, participate in

577

developing service plans, and share responsibility in

578

decisionmaking.

579

     f.  Implement the concept of managed risk.

580

     g. Provide, either directly or through contract, the

581

services of a person licensed pursuant to part I of chapter 464.

582

     h.  In addition to the training mandated in s. 429.52,

583

provide specialized training as defined by rule for facility

584

staff.

585

     5.4. Facilities licensed to provide extended congregate

586

care services are exempt from the criteria for continued

587

residency as set forth in rules adopted under s. 429.41.

588

Facilities so licensed must shall adopt their own requirements

589

within guidelines for continued residency set forth by rule.

590

However, such facilities may not serve residents who require 24-

591

hour nursing supervision. Facilities licensed to provide

592

extended congregate care services must shall provide each

593

resident with a written copy of facility policies governing

594

admission and retention.

595

     6.5. The primary purpose of extended congregate care

596

services is to allow residents, as they become more impaired,

597

the option of remaining in a familiar setting from which they

598

would otherwise be disqualified for continued residency. A

599

facility licensed to provide extended congregate care services

600

may also admit an individual who exceeds the admission criteria

601

for a facility with a standard license, if the individual is

602

determined appropriate for admission to the extended congregate

603

care facility.

604

     7.6. Before admission of an individual to a facility

605

licensed to provide extended congregate care services, the

606

individual must undergo a medical examination as provided in s.

607

429.26(4) and the facility must develop a preliminary service

608

plan for the individual as provided in s. 429.26.

609

     8.7. When a facility can no longer provide or arrange for

610

services in accordance with the resident's service plan and

611

needs and the facility's policy, the facility shall make

612

arrangements for relocating the person in accordance with s.

613

429.28(1)(k).

614

     9.8. Failure to provide extended congregate care services

615

may result in denial of extended congregate care license

616

renewal.

617

     9. No later than January 1 of each year, the department,

618

in consultation with the agency, shall prepare and submit to the

619

Governor, the President of the Senate, the Speaker of the House

620

of Representatives, and the chairs of appropriate legislative

621

committees, a report on the status of, and recommendations

622

related to, extended congregate care services. The status report

623

must include, but need not be limited to, the following

624

information:

625

     a. A description of the facilities licensed to provide

626

such services, including total number of beds licensed under

627

this part.

628

     b. The number and characteristics of residents receiving

629

such services.

630

     c. The types of services rendered that could not be

631

provided through a standard license.

632

     d. An analysis of deficiencies cited during licensure

633

inspections.

634

     e. The number of residents who required extended

635

congregate care services at admission and the source of

636

admission.

637

     f. Recommendations for statutory or regulatory changes.

638

     g. The availability of extended congregate care to state

639

clients residing in facilities licensed under this part and in

640

need of additional services, and recommendations for

641

appropriations to subsidize extended congregate care services

642

for such persons.

643

     h. Such other information as the department considers

644

appropriate.

645

     (c)  A limited nursing services license shall be issued to

646

a facility that provides services beyond those authorized in

647

paragraph (a) and as specified in this paragraph.

648

     1. To obtain a In order for limited nursing services

649

license to be provided in a facility licensed under this part,

650

the agency must first determine that all requirements

651

established in law and rule are met and must specifically

652

designate, on the facility's license, that such services may be

653

provided. Such designation may be made at the time of initial

654

licensure or relicensure, or upon request in writing by a

655

licensee under this part and part II of chapter 408.

656

Notification of approval or denial of such request shall be made

657

in accordance with part II of chapter 408. Existing

658

     2. Facilities applying for, and facilities currently

659

licensed qualifying to provide, limited nursing services must

660

shall have maintained a standard license and may not have been

661

subject to administrative sanctions that affect the health,

662

safety, and welfare of residents for the previous 2 years or

663

since initial licensure if the facility has been licensed for

664

less than 2 years.

665

     3.2. Facilities that are licensed to provide limited

666

nursing services shall maintain a written progress report on

667

each person who receives such nursing services, which report

668

describes the type, amount, duration, scope, and outcome of

669

services that are rendered and the general status of the

670

resident's health. A registered nurse representing the agency

671

shall visit such facilities at least twice a year to monitor

672

residents who are receiving limited nursing services and to

673

determine if the facility is in compliance with applicable

674

provisions of this part, part II of chapter 408, and related

675

rules. The monitoring visits may be provided through contractual

676

arrangements with appropriate community agencies. A registered

677

nurse shall also serve as part of the team that inspects the

678

such facility.

679

     4.3. A person who receives limited nursing services under

680

this part must meet the admission criteria established by the

681

agency for assisted living facilities. If When a resident no

682

longer meets the admission criteria for a facility licensed

683

under this part, arrangements for relocating the person shall be

684

made in accordance with s. 429.28(1)(k), unless the facility is

685

also licensed to provide extended congregate care services.

686

     Section 13.  Section 429.174, Florida Statutes, is amended

687

to read:

688

     429.174  Background screening; exemptions.--The owner or

689

administrator of an assisted living facility must conduct level

690

1 background screening, as set forth in chapter 435, on all

691

employees and contracted workers hired on or after October 1,

692

1998, who perform personal services or who have access to

693

resident living areas as defined in s. 429.02(16). The agency

694

may exempt an individual from employment disqualification as set

695

forth in s. 435.07 chapter 435. However, such person may not be

696

employed or resume employment pending the granting of an

697

exemption or until all appeals have been resolved in favor of

698

the person screened. Employees and contracted workers Such

699

persons shall be considered as having met the screening

700

requirements this requirement if:

701

     (1)  Proof of compliance with level 1 screening

702

requirements obtained to meet any professional license

703

requirements in this state is provided and accompanied, under

704

penalty of perjury, by a copy of the person's current

705

professional license and an affidavit of current compliance with

706

the background screening requirements.

707

     (2)  The person required to be screened has been

708

continuously employed in the same type of occupation for which

709

the person is seeking employment without a breach in service

710

which exceeds 180 days, and proof of compliance with the level 1

711

screening requirement which is no more than 2 years old is

712

provided. Proof of compliance shall be provided directly from

713

one employer or contractor to another, and not from the person

714

screened. Upon request, a copy of screening results shall be

715

provided by the employer or contractor retaining documentation

716

of the screening to the person screened.

717

     (3) The person required to be screened is employed by or

718

contracts with a corporation or business entity or related

719

corporation or business entity that owns, operates, or manages

720

more than one facility or agency licensed under this chapter,

721

and for whom a level 1 screening was conducted by the

722

corporation or business entity as a condition of initial or

723

continued employment.

724

     (4) The person being screened is responsible for paying

725

the fees associated with obtaining the required screening.

726

Payment for the screening shall be submitted to the agency. The

727

agency shall establish a schedule of fees to cover the costs of

728

level 1 and level 2 screening. Facilities may pay for these

729

costs. The Department of Law Enforcement shall charge the agency

730

for a level 1 or level 2 screening a rate sufficient to cover

731

the costs of screening pursuant to s. 943.053(3).

732

733

A contract worker who is retained on an emergency basis or for a

734

task involving repair or maintenance that will require the

735

contract worker to be on the premises for less than one day,

736

shall not be required to have a background screen under this

737

section, but must be required to sign in upon entering the

738

building, wear an identification badge, and sign out before

739

leaving the building. The facility shall maintain a log with the

740

information collected.

741

     Section 14.  Subsection (1) of section 429.255, Florida

742

Statutes, is amended to read:

743

     429.255  Use of personnel; emergency care.--

744

     (1)(a) Facility staff, including persons under contract to

745

the facility, facility employees staff, or volunteers, who are

746

licensed according to part I of chapter 464, or those persons

747

exempt under s. 464.022(1), and others as defined by rule, may

748

administer medications to residents, take residents' vital

749

signs, manage individual weekly pill organizers for residents

750

who self-administer medication, give prepackaged enemas ordered

751

by a physician, observe residents, document observations on the

752

appropriate resident's record, report observations to the

753

resident's physician, and contract or allow residents or a

754

resident's representative, designee, surrogate, guardian, or

755

attorney in fact to contract with a third party, provided

756

residents meet the criteria for appropriate placement as defined

757

in s. 429.26. Nursing assistants certified pursuant to part II

758

of chapter 464 may take residents' vital signs as directed by a

759

licensed nurse or physician.

760

     (b) Facility All staff, including persons under contract

761

to the facility and facility employees in facilities licensed

762

under this part shall exercise their professional responsibility

763

to observe residents, to document observations on the

764

appropriate resident's record, and to report the observations to

765

the resident's physician, and to provide needed services

766

competently. Volunteers shall have the same obligations but

767

shall report to a facility employee who will make the

768

appropriate notation in the resident's records. However, the

769

owner or administrator of the facility is shall be responsible

770

for determining that the resident receiving services is

771

appropriate for residence in the facility and for the provision

772

of and quality of care and services provided to the resident.

773

     (c)  In an emergency situation, licensed personnel may

774

carry out their professional duties pursuant to part I of

775

chapter 464 until emergency medical personnel assume

776

responsibility for care.

777

     Section 15.  Present subsections (8) through (12) of

778

section 429.26, Florida Statutes, are renumbered as sections (6)

779

through (10), respectively, and present subsections (1) through

780

(7) of that section, are amended to read:

781

     429.26  Appropriateness of placements; examinations of

782

residents.--

783

     (1)  The owner or administrator of a facility is

784

responsible for determining the appropriateness of admission of

785

an individual to the facility and for determining the continued

786

appropriateness of residence of an individual in the facility. A

787

determination shall be based upon an assessment of the

788

strengths, needs, and preferences of the resident, the care and

789

services offered or arranged for by the facility in accordance

790

with facility policy, and any limitations in law or rule related

791

to admission criteria or continued residency for the type of

792

license held by the facility under this part. Except as provided

793

in s. 429.28(1)(k), a resident may not be moved from one

794

facility to another without consultation with and agreement from

795

the resident or, if applicable, the resident's representative or

796

designee or the resident's family, guardian, surrogate, or

797

attorney in fact. If In the case of a resident who has been

798

placed by the department or the Department of Children and

799

Family Services, the administrator must notify the appropriate

800

contact person in the applicable department.

801

     (2) A physician, physician assistant, or nurse

802

practitioner who is employed by an assisted living facility to

803

provide an initial examination for admission purposes may not

804

have financial interest in the facility.

805

     (3) Persons licensed under part I of chapter 464 who are

806

employed by or under contract with a facility shall, on a

807

routine basis or at least monthly, perform a nursing assessment

808

of the residents for whom they are providing nursing services

809

ordered by a physician, except administration of medication, and

810

shall document such assessment, including any substantial

811

changes in a resident's status which may necessitate relocation

812

to a nursing home, hospital, or specialized health care

813

facility. Such records shall be maintained in the facility for

814

inspection by the agency and shall be forwarded to the

815

resident's case manager, if applicable.

816

     (2)(4) If possible, each resident shall have been examined

817

by a licensed physician, a licensed physician assistant, or a

818

licensed nurse practitioner within 60 days before admission to

819

the facility. The person conducting an examination under this

820

subsection may not have financial interest in the facility. The

821

signed and completed medical examination report shall be

822

submitted to the owner or administrator of the facility who

823

shall use the information contained in the report therein to

824

assist in determining the determination of the appropriateness

825

of the resident's admission and continued stay in the facility

826

and to develop a service plan for the resident. The medical

827

examination report and service plan shall become a permanent

828

part of the record of the resident at the facility and shall be

829

made available to the agency during inspection or upon request.

830

An assessment that has been completed through the Comprehensive

831

Assessment and Review for Long-Term Care Services (CARES)

832

Program fulfills the requirements for a medical examination

833

under this subsection and s. 429.07(3)(b)6.

834

     (a)(5) Except as provided in s. 429.07, if a medical

835

examination has not been completed within 60 days before the

836

admission of the resident to the facility, medical personnel a

837

licensed physician, licensed physician assistant, or licensed

838

nurse practitioner shall examine the resident and complete a

839

medical examination form provided by the agency within 30 days

840

following the admission to the facility to enable the facility

841

owner or administrator to determine the appropriateness of the

842

admission. The medical examination form shall become a permanent

843

part of the record of the resident at the facility and shall be

844

made available to the agency during inspection by the agency or

845

upon request.

846

     (b)(6) Any resident accepted in a facility and placed by

847

the department or the Department of Children and Family Services

848

must be shall have been examined by medical personnel within 30

849

days before placement in the facility and recorded on a medical

850

examination form provided by the agency. The examination shall

851

include an assessment of the appropriateness of placement in a

852

facility. The findings of this examination shall be recorded on

853

the examination form provided by the agency. The completed form

854

shall accompany the resident and shall be submitted to the

855

facility owner or administrator. For Additionally, in the case

856

of a mental health resident, the Department of Children and

857

Family Services must provide documentation that the individual

858

has been assessed by a psychiatrist, clinical psychologist,

859

clinical social worker, or psychiatric nurse, or an individual

860

who is supervised by one of these professionals, and determined

861

to be appropriate to reside in an assisted living facility. The

862

documentation must be in the facility within 30 days after the

863

mental health resident has been admitted to the facility. An

864

evaluation completed upon discharge from a state mental hospital

865

meets the requirements of this subsection related to

866

appropriateness for placement as a mental health resident

867

providing it was completed within 90 days prior to admission to

868

the facility. The applicable department shall provide to the

869

facility administrator any information about the resident that

870

would help the administrator meet his or her responsibilities

871

under this section subsection (1). Further, department personnel

872

shall explain to the facility operator any special needs of the

873

resident and advise the operator whom to call should problems

874

arise. The applicable department shall advise and assist the

875

facility administrator where the special needs of residents who

876

are recipients of optional state supplementation require such

877

assistance.

878

     (3) A level 1 criminal background screening as defined in

879

chapter 435 of a prospective resident must be conducted by the

880

facility before admission or immediately after admission at the

881

resident's expense. The information obtained may be used by the

882

facility to assess the needs of the resident and the care and

883

services offered or arranged by the facility in accordance with

884

this section. The Agency's employee background screening

885

database may not be used for resident screening. If a resident

886

transfers between facilities, the resident's background

887

screening results shall be transferred with the resident.

888

     (4) Persons licensed under part I of chapter 464 who are

889

employed by or under contract with a facility shall at least

890

monthly, perform a nursing assessment of residents for whom they

891

are providing nursing services ordered by a physician, except

892

administration of medication, and shall document such

893

assessment, including any substantial change in a resident's

894

status which may necessitate relocation to a nursing home,

895

hospital, or specialized health care facility. The records must

896

be maintained in the facility for inspection by the agency and

897

shall be forwarded to the resident's case manager, if

898

applicable.

899

     (5)(7) Residents shall be periodically assessed to

900

determine if the resident is competent to handle his or her

901

personal and financial affairs, and, if not, whether a

902

responsible person such as a resident representative or

903

designee, guardian, surrogate, or attorney in fact is available

904

to make decisions on behalf of the resident. If a resident is

905

having difficulty handling his or her personal or financial

906

affairs, because of a decline in health or cognitive abilities,

907

the owner or administrator shall contact the resident's

908

representative or designee, guardian, surrogate or attorney-in-

909

fact. If a resident does not have family or a legal

910

representative to make decisions on his or her behalf, the owner

911

or administrator must contact the Florida Abuse Hotline. The

912

facility must notify a licensed physician when a resident

913

exhibits signs of dementia or cognitive impairment or has a

914

change of condition in order to rule out the presence of an

915

underlying physiological condition that may be contributing to

916

such dementia or impairment. The notification must occur within

917

30 days after the acknowledgment of such signs by facility

918

staff. If an underlying condition is determined to exist, the

919

facility shall arrange, with the appropriate health care

920

provider, the necessary care and services to treat the

921

condition.

922

     Section 16.  Subsections (3) through (8) of section 429.27,

923

Florida Statutes, are renumbered as subsections (6) through

924

(11), respectively, and subsections (1) and (2) of that section,

925

are amended to read:

926

     429.27  Property and personal affairs of residents.--

927

     (1)(a) A resident shall be given the option of using his

928

or her own belongings, as space permits; choosing his or her

929

roommate; and, whenever possible, unless the resident is

930

adjudicated incompetent or incapacitated under state law,

931

managing his or her own affairs.

932

     (2)(b) The admission of a resident to a facility does and

933

his or her presence therein shall not confer on the facility or

934

its owner, administrator, staff employees, or representatives

935

any authority to manage, use, or dispose of any property of the

936

resident or to make financial or health care decisions on behalf

937

of the resident; nor shall such admission or presence confer on

938

any of such persons any authority or responsibility for the

939

personal affairs of the resident, except if that which may be

940

necessary for the safe management of the facility or for the

941

safety of the resident.

942

     (3)(2) A facility, or an owner, administrator, staff

943

employee, or representative thereof, may not act as the

944

resident's representative or designee, guardian, health care

945

surrogate, trustee, or conservator for a any resident of the

946

assisted living facility or any of the such resident's property

947

unless the person is a relative of the resident.

948

     (4) A facility An owner, administrator, or staff member,

949

or representative thereof, may not act as a competent resident's

950

payee for social security, veteran's, or railroad benefits

951

without the consent of the resident. Any facility whose owner,

952

administrator, or staff, or representative thereof who, serves

953

as representative payee for a any resident must of the facility

954

shall file a surety bond with the agency in an amount equal to

955

twice the average monthly aggregate income or personal funds due

956

to residents, or expendable for his or her their account, which

957

are received by a facility.

958

     (5) Any facility whose owner, administrator, or staff, or

959

a representative thereof who, is granted power of attorney for a

960

any resident must of the facility shall file a surety bond with

961

the agency for each resident for whom such power of attorney is

962

granted. The surety bond must shall be in an amount equal to

963

twice the average monthly income of the resident, plus the value

964

of any resident's property under the control of the attorney in

965

fact. The bond must shall be executed by the facility as

966

principal and a licensed surety company. The bond shall be

967

conditioned upon the faithful compliance of the facility with

968

this section and shall run to the agency for the benefit of any

969

resident who suffers a financial loss as a result of the misuse

970

or misappropriation by a facility of funds held pursuant to this

971

subsection. Any surety company that cancels or does not renew

972

the bond of any licensee shall notify the agency in writing not

973

less than 30 days in advance of such action, giving the reason

974

for the cancellation or nonrenewal. Any facility owner,

975

administrator, or staff, or representative thereof, who is

976

granted power of attorney for a any resident of the facility

977

shall, on a monthly basis, be required to provide the resident

978

with a written statement of any transaction made on behalf of

979

the resident pursuant to this subsection, and a copy of such

980

statement given to the resident shall be retained in each

981

resident's file and available for agency inspection.

982

     Section 17.  Paragraphs (k) and (l) of subsection (1) and

983

subsection (3) of section 429.28, Florida Statutes, are amended

984

to read:

985

     429.28  Resident bill of rights.--

986

     (1)  No resident of a facility shall be deprived of any

987

civil or legal rights, benefits, or privileges guaranteed by

988

law, the Constitution of the State of Florida, or the

989

Constitution of the United States as a resident of a facility.

990

Every resident of a facility shall have the right to:

991

     (k) At least 45 days' written notice of relocation or

992

termination of residency from the facility unless, for medical

993

reasons, the resident is certified by a physician to require an

994

emergency relocation to a facility providing a more skilled

995

level of care or the resident engages in a pattern of conduct

996

that is harmful or offensive to other residents. The notice must

997

specify the reasons for the relocation or termination and a copy

998

of the notice must be sent by registered mail to the resident's

999

representative or designee, guardian, surrogate, attorney in

1000

fact, the local ombudsman council, and the agency at the same

1001

time the notice is delivered to the resident. The agency shall

1002

compile an annual report summarizing the information received in

1003

the notice, including the number and reasons for relocation or

1004

termination of facility residents, type and size of facilities,

1005

and other information that the agency considers relevant, which

1006

shall be submitted to the Governor, the President of the Senate,

1007

and the Speaker of the House of Representatives. In the case of

1008

a resident who has been adjudicated mentally incapacitated, the

1009

guardian shall be given at least 45 days' notice of a

1010

nonemergency relocation or residency termination. Reasons for

1011

relocation shall be set forth in writing. In order for a

1012

facility to terminate the residency of an individual without

1013

notice as provided in this paragraph herein, the facility must

1014

shall show good cause in a court of competent jurisdiction.

1015

     (l)  Present grievances and recommend changes in policies,

1016

procedures, and services to the staff of the facility, governing

1017

officials, or any other person without restraint, interference,

1018

coercion, discrimination, or reprisal. Each facility shall

1019

establish a written grievance procedure to facilitate the

1020

residents' exercise of this right which must include, at a

1021

minimum, maintaining a written record of each grievance, the

1022

stated reason for the grievance, actions taken by the facility,

1023

and reporting each grievance within 3 business days after

1024

receiving the grievance to the local ombudsman council. Each

1025

facility must accept grievances orally and may accept grievances

1026

in writing. The local ombudsman council shall maintain a record

1027

of all grievances received from each facility in the local area

1028

which shall be submitted by the local council to the Office of

1029

the State Long-Term Care Ombudsman pursuant to s. 400.0089. This

1030

right also includes access to ombudsman volunteers and advocates

1031

and the right to be a member of, to be active in, and to

1032

associate with advocacy or special interest groups.

1033

     (3)(a) The agency shall conduct a survey to determine

1034

general compliance with facility standards and compliance with

1035

residents' rights as a prerequisite to initial licensure or

1036

licensure renewal.

1037

     (b) In order to determine whether the facility is

1038

adequately protecting residents' rights, the agency's biennial

1039

survey shall include private informal conversations with a

1040

sample of residents and consultation with the ombudsman council

1041

in the planning and service area in which the facility is

1042

located to discuss residents' experiences within the facility.

1043

     (c) During any calendar year in which no survey is

1044

conducted, the agency shall conduct at least one monitoring

1045

visit of each facility cited in the previous year for a class I

1046

or class II violation, or more than three uncorrected class III

1047

violations.

1048

     (d) The agency may conduct periodic followup inspections

1049

as necessary to monitor the compliance of facilities with a

1050

history of any class I, class II, or class III violations that

1051

threaten the health, safety, or security of residents.

1052

     (e) The agency may conduct complaint investigations as

1053

warranted to investigate any allegations of noncompliance with

1054

requirements required under this part or rules adopted under

1055

this part.

1056

     Section 18.  Subsection (1) of section 429.294, Florida

1057

Statutes, is amended to read:

1058

     429.294  Availability of facility records for investigation

1059

of resident's rights violations and defenses; penalty.--

1060

     (1)  Failure to provide complete copies of a resident's

1061

records, including, but not limited to, all medical records and

1062

the resident's chart, within the control or possession of the

1063

facility within 10 days, in accordance with the provisions of s.

1064

400.145, shall constitute evidence of failure of that party to

1065

comply with good faith discovery requirements and shall waive

1066

the good faith certificate and presuit notice requirements under

1067

this part by the requesting party.

1068

     Section 19.  Section 429.34, Florida Statutes, is amended

1069

to read:

1070

     429.34  Right of entry and inspection.--In addition to the

1071

requirements of s. 408.811:,

1072

     (1) Any duly designated officer or employee of the

1073

department, the Department of Children and Family Services, the

1074

Medicaid Fraud Control Unit of the Office of the Attorney

1075

General, the state or local fire marshal, or a member of the

1076

state or local long-term care ombudsman council shall have the

1077

right to enter unannounced upon and into the premises of any

1078

facility licensed pursuant to this part in order to determine

1079

the state of compliance with the provisions of this part, part

1080

II of chapter 408, and applicable rules. Data collected by the

1081

state or local long-term care ombudsman councils or the state or

1082

local advocacy councils may be used by the agency in

1083

investigations involving violations of regulatory standards.

1084

     (2) Every 15 months the agency shall conduct at least one

1085

unannounced inspection to determine compliance with this chapter

1086

and related rules including minimum standards of quality and

1087

adequacy of care, and the rights of residents. Two additional

1088

surveys shall be conducted every 6 months for the next year if

1089

the facility has been cited for a class I deficiency or two or

1090

more class II deficiencies arising from separate surveys or

1091

investigations within a 60-day period. In addition to any fines

1092

imposed on a facility under s. 429.19, the agency shall assess a

1093

fine of $160 per bed for each of the additional two surveys. The

1094

agency shall adjust this fine by the change in the Consumer

1095

Price Index, based on the 12 months immediately preceding the

1096

change, to cover the cost of the additional two surveys. The

1097

agency shall verify through subsequent inspections that any

1098

deficiency identified during an inspection is corrected.

1099

However, the agency may verify the correction of a class III or

1100

class IV deficiency unrelated to resident rights or resident

1101

care without reinspecting the facility if adequate written

1102

documentation has been received from the facility which provides

1103

assurance that the deficiency has been corrected.

1104

     Section 20.  Paragraphs (k) and (l) of subsection (1) of

1105

section 429.41, Florida Statutes, are redesignated as paragraphs

1106

(l) and (m), respectively, and a new paragraph (k) is added to

1107

that subsection, to read:

1108

     (1)  It is the intent of the Legislature that rules

1109

published and enforced pursuant to this section shall include

1110

criteria by which a reasonable and consistent quality of

1111

resident care and quality of life may be ensured and the results

1112

of such resident care may be demonstrated. Such rules shall also

1113

ensure a safe and sanitary environment that is residential and

1114

noninstitutional in design or nature. It is further intended

1115

that reasonable efforts be made to accommodate the needs and

1116

preferences of residents to enhance the quality of life in a

1117

facility. The agency, in consultation with the department, may

1118

adopt rules to administer the requirements of part II of chapter

1119

408. In order to provide safe and sanitary facilities and the

1120

highest quality of resident care accommodating the needs and

1121

preferences of residents, the department, in consultation with

1122

the agency, the Department of Children and Family Services, and

1123

the Department of Health, shall adopt rules, policies, and

1124

procedures to administer this part, which must include

1125

reasonable and fair minimum standards in relation to:

1126

     (k) The requirement that all residents have service plans.

1127

The service plan must be reviewed and updated annually; however,

1128

for a resident receiving nursing services ordered by a

1129

physician, except administration of medication, the plan must be

1130

reviewed and updated quarterly and whenever a resident

1131

experiences a significant change in condition.

1132

     Section 21. Subsection (14) of section 429.65, Florida

1133

Statutes, is created to read:

1134

     (14) "Reside" means the licensee or applicant lives in the

1135

adult family care home as a primary residence. For the purposes

1136

of this part, any two of the following documents which include

1137

the adult family care home address and the name of the licensee

1138

or applicant may be accepted by the agency as proof that the

1139

licensee or applicant resides in the adult family care home:

1140

     (a) Homestead exemption documentation;

1141

     (b) Lease or rental agreement accompanied by a

1142

corresponding utility bill;

1143

     (c) Personal identification issued by a state or federal

1144

agency.

1145

     (14)(15) "Resident" means a person receiving room, board,

1146

and personal care in an adult family-care home.

1147

     Section 22.  Subsection (4) of section 429.67, Florida

1148

Statutes, is amended to read:

1149

     429.67  Licensure.--

1150

     (4)  Upon receipt of a completed license application or

1151

license renewal, and the fee, the agency shall initiate a level

1152

1 background screening as provided under chapter 435 on the

1153

adult family-care home provider, the designated relief person,

1154

all adult household members, and all staff members, and any

1155

other person who provides personal services to residents or who

1156

have routine access to the adult family-care home.

1157

     (a)  Proof of compliance with level 1 screening standards

1158

which has been submitted within the previous 5 years to meet any

1159

facility or professional licensure requirements of the agency or

1160

the Department of Health satisfies the requirements of this

1161

subsection. Such proof must be accompanied, under penalty of

1162

perjury, by a copy of the person's current professional license

1163

and an affidavit of current compliance with the background

1164

screening requirements.

1165

     (b)  The person required to be screened must have been

1166

continuously employed in the same type of occupation for which

1167

the person is seeking employment without a breach in service

1168

that exceeds 180 days, and proof of compliance with the level 1

1169

screening requirement which is no more than 2 years old must be

1170

provided. Proof of compliance shall be provided directly from

1171

one employer or contractor to another, and not from the person

1172

screened. Upon request, a copy of screening results shall be

1173

provided to the person screened by the employer retaining

1174

documentation of the screening.

1175

     Section 23.  Subsection (3) is added to section 429.69,

1176

Florida Statutes, to read:

1177

     429.69  Denial, revocation, and suspension of a

1178

license.--In addition to the requirements of part II of chapter

1179

408, the agency may deny, suspend, and revoke a license for any

1180

of the following reasons:

1181

     (3) Failure of the adult family-care home provider who

1182

owns or rents the home to live in the home.

1183

     Section 24.  Paragraph (b) of subsection (1) of section

1184

429.73, Florida Statutes, is amended to read:

1185

     429.73  Rules and standards relating to adult family-care

1186

homes.--

1187

     (1)  The agency, in consultation with the department, may

1188

adopt rules to administer the requirements of part II of chapter

1189

408. The department, in consultation with the Department of

1190

Health, the Department of Children and Family Services, and the

1191

agency shall, by rule, establish minimum standards to ensure the

1192

health, safety, and well-being of each resident in the adult

1193

family-care home pursuant to this part. The rules must address:

1194

     (b)  Services that must be provided to all residents of an

1195

adult family-care home and standards for such services, which

1196

must include, but need not be limited to:

1197

     1.  Room and board.

1198

     2.  Assistance necessary to perform the activities of daily

1199

living.

1200

     3.  Assistance necessary to administer medication.

1201

     4.  Supervision of residents.

1202

     5. Health monitoring, including periodic assessments to

1203

determine if the resident is competent to handle his or her

1204

personal and financial affairs, and, if not, whether a

1205

responsible person such as a guardian, surrogate, or attorney in

1206

fact is available to make decisions on behalf of the resident.

1207

     6.  Social and leisure activities.

1208

     Section 25.  Subsections (2) and (3) of section 435.03,

1209

Florida Statutes, are amended to read:

1210

     435.03  Level 1 screening standards.--

1211

     (2)  Any person for whom employment screening is required

1212

by statute must not have been convicted of found guilty of,

1213

regardless of adjudication, or entered a plea of guilty or nolo

1214

contendere or guilty to, regardless of adjudication, to any

1215

offense prohibited under any of the following provisions of the

1216

Florida statutes or under any similar statute of another

1217

jurisdiction:

1218

     (a)  Section 393.135, relating to sexual misconduct with

1219

certain developmentally disabled clients and reporting of such

1220

sexual misconduct.

1221

     (b)  Section 394.4593, relating to sexual misconduct with

1222

certain mental health patients and reporting of such sexual

1223

misconduct.

1224

     (c)  Section 415.111, relating to abuse, neglect, or

1225

exploitation of a vulnerable adult.

1226

     (d)  Section 782.04, relating to murder.

1227

     (e)  Section 782.07, relating to manslaughter, aggravated

1228

manslaughter of an elderly person or disabled adult, or

1229

aggravated manslaughter of a child.

1230

     (f)  Section 782.071, relating to vehicular homicide.

1231

     (g)  Section 782.09, relating to killing of an unborn quick

1232

child by injury to the mother.

1233

     (h)  Section 784.011, relating to assault, if the victim of

1234

the offense was a minor.

1235

     (i)  Section 784.021, relating to aggravated assault.

1236

     (j)  Section 784.03, relating to battery, if the victim of

1237

the offense was a minor.

1238

     (k)  Section 784.045, relating to aggravated battery.

1239

     (l)  Section 787.01, relating to kidnapping.

1240

     (m)  Section 787.02, relating to false imprisonment.

1241

     (n)  Section 794.011, relating to sexual battery.

1242

     (o)  Former s. 794.041, relating to prohibited acts of

1243

persons in familial or custodial authority.

1244

     (p)  Chapter 796, relating to prostitution.

1245

     (q)  Section 798.02, relating to lewd and lascivious

1246

behavior.

1247

     (r)  Chapter 800, relating to lewdness and indecent

1248

exposure.

1249

     (s)  Section 806.01, relating to arson.

1250

     (t)  Chapter 812, relating to theft, robbery, and related

1251

crimes, if the offense was a felony.

1252

     (u)  Section 817.563, relating to fraudulent sale of

1253

controlled substances, only if the offense was a felony.

1254

     (v)  Section 825.102, relating to abuse, aggravated abuse,

1255

or neglect of an elderly person or disabled adult.

1256

     (w)  Section 825.1025, relating to lewd or lascivious

1257

offenses committed upon or in the presence of an elderly person

1258

or disabled adult.

1259

     (x)  Section 825.103, relating to exploitation of an

1260

elderly person or disabled adult, if the offense was a felony.

1261

     (y)  Section 826.04, relating to incest.

1262

     (z)  Section 827.03, relating to child abuse, aggravated

1263

child abuse, or neglect of a child.

1264

     (aa)  Section 827.04, relating to contributing to the

1265

delinquency or dependency of a child.

1266

     (bb)  Former s. 827.05, relating to negligent treatment of

1267

children.

1268

     (cc)  Section 827.071, relating to sexual performance by a

1269

child.

1270

     (dd)  Chapter 847, relating to obscene literature.

1271

     (ee)  Chapter 893, relating to drug abuse prevention and

1272

control, only if the offense was a felony or if any other person

1273

involved in the offense was a minor.

1274

     (ff)  Section 916.1075, relating to sexual misconduct with

1275

certain forensic clients and reporting of such sexual

1276

misconduct.

1277

     (3)  Standards must also ensure that the person:

1278

     (a)  For employees and employers licensed or registered

1279

pursuant to chapter 408, part II400 or chapter 429, and for

1280

employees and employers of developmental disabilities

1281

institutions as defined in s. 393.063, intermediate care

1282

facilities for the developmentally disabled as defined in s.

1283

400.960, and mental health treatment facilities as defined in s.

1284

394.455, has not been convicted of, or entered a plea of guilty

1285

or nolo contendere, regardless of adjudication, to offenses

1286

prohibited under any of the following statutes or under any

1287

similar statute of another jurisdiction: meets the requirements

1288

of this chapter.

1289

     1. Sections 409.920 and 409.9201, relating to Medicaid

1290

fraud.

1291

     2. Chapter 429, relating to assisted care communities.

1292

     3. Chapter 784, relating to assault, battery, and culpable

1293

negligence, if the offense is a felony.

1294

     4. Section 810.02, relating to burglary, if the offense is

1295

a felony.

1296

     5. Section 817.034, relating to communications fraud.

1297

     6. Section 817.234, relating to fraudulent insurance

1298

claims.

1299

     7. Section 817.505, relating to patient brokering.

1300

     8. Section 817.568, relating to identification theft.

1301

     9. Sections 817.60 and 817.61, relating to credit cards,

1302

if the offense is a felony.

1303

     10. Sections 831.01, 831.02, 831.07, 831.09, 831.30, and

1304

831.31 relating to forgery, uttering, and counterfeiting.

1305

     (b)  Has not committed an act that constitutes domestic

1306

violence as defined in s. 741.28.

1307

     Section 26.  Subsections (2) and (4) of section 435.04,

1308

Florida Statutes, are amended to read:

1309

     435.04  Level 2 screening standards.--

1310

     (2)  The security background investigations under this

1311

section must ensure that no persons subject to the provisions of

1312

this section have been convicted found guilty of, regardless of

1313

adjudication, or entered a plea of guilty or nolo contendere or

1314

guilty to, regardless of adjudication, to any offense prohibited

1315

under any of the following provisions of the Florida statutes or

1316

under any similar statute of another jurisdiction:

1317

     (a)  Section 393.135, relating to sexual misconduct with

1318

certain developmentally disabled clients and reporting of such

1319

sexual misconduct.

1320

     (b)  Section 394.4593, relating to sexual misconduct with

1321

certain mental health patients and reporting of such sexual

1322

misconduct.

1323

     (c)  Section 415.111, relating to adult abuse, neglect, or

1324

exploitation of aged persons or disabled adults.

1325

     (d)  Section 782.04, relating to murder.

1326

     (e)  Section 782.07, relating to manslaughter, aggravated

1327

manslaughter of an elderly person or disabled adult, or

1328

aggravated manslaughter of a child.

1329

     (f)  Section 782.071, relating to vehicular homicide.

1330

     (g)  Section 782.09, relating to killing of an unborn quick

1331

child by injury to the mother.

1332

     (h)  Section 784.011, relating to assault, if the victim of

1333

the offense was a minor.

1334

     (i)  Section 784.021, relating to aggravated assault.

1335

     (j)  Section 784.03, relating to battery, if the victim of

1336

the offense was a minor.

1337

     (k)  Section 784.045, relating to aggravated battery.

1338

     (l)  Section 784.075, relating to battery on a detention or

1339

commitment facility staff.

1340

     (m)  Section 787.01, relating to kidnapping.

1341

     (n)  Section 787.02, relating to false imprisonment.

1342

     (o)  Section 787.04(2), relating to taking, enticing, or

1343

removing a child beyond the state limits with criminal intent

1344

pending custody proceedings.

1345

     (p)  Section 787.04(3), relating to carrying a child beyond

1346

the state lines with criminal intent to avoid producing a child

1347

at a custody hearing or delivering the child to the designated

1348

person.

1349

     (q)  Section 790.115(1), relating to exhibiting firearms or

1350

weapons within 1,000 feet of a school.

1351

     (r)  Section 790.115(2)(b), relating to possessing an

1352

electric weapon or device, destructive device, or other weapon

1353

on school property.

1354

     (s)  Section 794.011, relating to sexual battery.

1355

     (t)  Former s. 794.041, relating to prohibited acts of

1356

persons in familial or custodial authority.

1357

     (u)  Chapter 796, relating to prostitution.

1358

     (v)  Section 798.02, relating to lewd and lascivious

1359

behavior.

1360

     (w)  Chapter 800, relating to lewdness and indecent

1361

exposure.

1362

     (x)  Section 806.01, relating to arson.

1363

     (y)  Chapter 812, relating to theft, robbery, and related

1364

crimes, if the offense is a felony.

1365

     (z)  Section 817.563, relating to fraudulent sale of

1366

controlled substances, only if the offense was a felony.

1367

     (aa)  Section 825.102, relating to abuse, aggravated abuse,

1368

or neglect of an elderly person or disabled adult.

1369

     (bb)  Section 825.1025, relating to lewd or lascivious

1370

offenses committed upon or in the presence of an elderly person

1371

or disabled adult.

1372

     (cc)  Section 825.103, relating to exploitation of an

1373

elderly person or disabled adult, if the offense was a felony.

1374

     (dd)  Section 826.04, relating to incest.

1375

     (ee)  Section 827.03, relating to child abuse, aggravated

1376

child abuse, or neglect of a child.

1377

     (ff)  Section 827.04, relating to contributing to the

1378

delinquency or dependency of a child.

1379

     (gg)  Former s. 827.05, relating to negligent treatment of

1380

children.

1381

     (hh)  Section 827.071, relating to sexual performance by a

1382

child.

1383

     (ii)  Section 843.01, relating to resisting arrest with

1384

violence.

1385

     (jj)  Section 843.025, relating to depriving a law

1386

enforcement, correctional, or correctional probation officer

1387

means of protection or communication.

1388

     (kk)  Section 843.12, relating to aiding in an escape.

1389

     (ll)  Section 843.13, relating to aiding in the escape of

1390

juvenile inmates in correctional institutions.

1391

     (mm)  Chapter 847, relating to obscene literature.

1392

     (nn)  Section 874.05(1), relating to encouraging or

1393

recruiting another to join a criminal gang.

1394

     (oo)  Chapter 893, relating to drug abuse prevention and

1395

control, only if the offense was a felony or if any other person

1396

involved in the offense was a minor.

1397

     (pp)  Section 916.1075, relating to sexual misconduct with

1398

certain forensic clients and reporting of such sexual

1399

misconduct.

1400

     (qq)  Section 944.35(3), relating to inflicting cruel or

1401

inhuman treatment on an inmate resulting in great bodily harm.

1402

     (rr)  Section 944.46, relating to harboring, concealing, or

1403

aiding an escaped prisoner.

1404

     (ss)  Section 944.47, relating to introduction of

1405

contraband into a correctional facility.

1406

     (tt)  Section 985.701, relating to sexual misconduct in

1407

juvenile justice programs.

1408

     (uu)  Section 985.711, relating to contraband introduced

1409

into detention facilities.

1410

     (4)  Standards must also ensure that the person:

1411

     (a)  For employees or employers licensed or registered

1412

pursuant to chapter 408, part II 400 or chapter 429, and for

1413

employees and employers of developmental disabilities

1414

institutions as defined in s. 393.063, and mental health

1415

treatment facilities as defined in s. 394.455, has not been

1416

convicted of, or entered a plea of guilty or nolo contendere,

1417

regardless of adjudication, to offenses prohibited under any of

1418

the following statutes or under similar statutes of another

1419

jurisdiction: does not have a confirmed report of abuse,

1420

neglect, or exploitation as defined in s. 415.102(6), which has

1421

been uncontested or upheld under s. 415.103.

1422

     1. Sections 409.920 and 409.9201, relating to Medicaid

1423

fraud.

1424

     2. Chapter 429, relating to assisted care communities.

1425

     3. Chapter 784, relating to assault, battery, and culpable

1426

negligence, if the offense is a felony.

1427

     4. Section 810.02, relating to burglary, if the offense is

1428

a felony.

1429

     5. Section 817.034, relating to communications fraud.

1430

     6. Section 817.234, relating to fraudulent insurance

1431

claims.

1432

     7. Section 817.505, relating to patient brokering.

1433

     8. Section 817.568, relating to identification theft.

1434

     9. Sections 817.60 and 817.61, relating to credit cards,

1435

if the offense is a felony.

1436

     10. Sections 831.01, 831.02, 831.07, 831.09, 831.30, and

1437

831.31 relating to forgery, uttering, and counterfeiting.

1438

     (b)  Has not committed an act that constitutes domestic

1439

violence as defined in s. 741.28 s. 741.30.

1440

     Section 27. Subsection (13) of section 400.141, subsection

1441

(3)of section 408.809, subsection (2) of section 429.08, and

1442

subsection (5) of section 429.41, Florida Statutes, are

1443

repealed.

1444

     Section 28.  Paragraph (h) of subsection (3) of section

1445

430.80, Florida Statutes, is amended to read:

1446

     430.80  Implementation of a teaching nursing home pilot

1447

project.--

1448

     (3)  To be designated as a teaching nursing home, a nursing

1449

home licensee must, at a minimum:

1450

     (h) Maintain insurance coverage pursuant to s. 400.141(19)

1451

s. 400.141(20) or proof of financial responsibility in a minimum

1452

amount of $750,000. Such Proof of financial responsibility may

1453

include:

1454

     1.  Maintaining an escrow account consisting of cash or

1455

assets eligible for deposit in accordance with s. 625.52; or

1456

     2. Obtaining and maintaining, pursuant to chapter 675, an

1457

unexpired, irrevocable, nontransferable and nonassignable letter

1458

of credit issued by a any bank or savings association organized

1459

and existing under the laws of this state or a any bank or

1460

savings association organized under the laws of the United

1461

States that has its principal place of business in this state or

1462

has a branch office which is authorized to receive deposits in

1463

this state. The letter of credit shall be used to satisfy the

1464

obligation of the facility to the claimant upon presentment of a

1465

final judgment indicating liability and awarding damages to be

1466

paid by the facility or upon presentment of a settlement

1467

agreement signed by all parties if the to the agreement when

1468

such final judgment or settlement is a result of a liability

1469

claim against the facility.

1470

     Section 29.  Subsection (13) of section 651.118, Florida

1471

Statutes, is amended to read:

1472

     651.118  Agency for Health Care Administration;

1473

certificates of need; sheltered beds; community beds.--

1474

     (13) Residents, as defined in this chapter, are not

1475

considered new admissions for the purpose of s. 400.141(14)(d)

1476

s. 400.141(15)(d).

1477

     Section 30.  This act shall take effect October 1, 2008.

1478

1479

1480

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

1481

And the title is amended as follows:

1482

     Delete everything before the enacting clause

1483

and insert:

1484

A bill to be entitled

1485

An act relating to adult protection and care; amending s.

1486

322.142, F.S.; authorizing the Department of Children and

1487

Family Services to obtain copies of driver's license files

1488

maintained by the Department of Highway Safety and Motor

1489

Vehicles for the purpose of conducting protective

1490

investigations; amending s. 400.141, F.S.; requiring a

1491

criminal records check to be conducted on all nursing home

1492

residents; amending s. 400.19, F.S.; revising provisions

1493

relating to unannounced inspections; amending s. 400.215,

1494

F.S.; requiring contracted workers employed in a nursing

1495

home to submit to background screening; prohibiting

1496

employees and contracted workers who do not meet

1497

background screening requirements from being employed in a

1498

nursing home; providing certain exceptions; deleting an

1499

obsolete provision; amending s. 408.809, F.S.; requiring

1500

the agency to establish a fee schedule to cover the cost

1501

of a level 1 or level 2 screening and giving the agency

1502

rule making authority; amending s. 408.810, F.S.;

1503

requiring health care facilities regulated by the Agency

1504

for Health Care Administration to post certain information

1505

in the facility and allowing the agency to charge a fee to

1506

cover production and distribution; amending s. 408.811,

1507

F.S.; providing that agency employees who provide advance

1508

notice of unannounced agency inspections are subject to

1509

suspension, providing a timeline and process for

1510

correction of deficiencies, and providing that the agency

1511

may provide electronic access to documents; amending s.

1512

415.103, F.S.; requiring certain reports to the central

1513

abuse hotline relating to vulnerable adults to be

1514

immediately transferred to the county sheriff's office;

1515

amending s. 415.1051, F.S.; authorizing the Department of

1516

Children and Family Services to file the petition to

1517

determine incapacity in adult protection proceedings;

1518

prohibiting the department from serving as the guardian or

1519

providing legal counsel to the guardian; amending s.

1520

415.112, F.S.; specifying rules to be adopted by the

1521

Department of Children and Family Services relating to

1522

adult protective services under ch. 415, F.S.; amending s.

1523

429.02, F.S.; revising the definition of "service plan" to

1524

remove the limitation that plans are required only in

1525

assisted living facilities that have an extended

1526

congregate care license and providing that the agency

1527

develop a service plan form; amending s. 429.07, F.S.;

1528

providing that license requirements for specialty licenses

1529

apply to current licensees as well as applicants for an

1530

extended congregate care and limited nursing license;

1531

conforming a cross-reference; amending s. 429.174, F.S.;

1532

requiring certain employees and contracted workers in

1533

assisted living facilities to submit to background

1534

screening; prohibiting employees and contracted workers

1535

who do not meet background screening requirements from

1536

being employed in an assisted living facility; providing

1537

certain exceptions; requiring the person being screened to

1538

pay for the cost of screening; amending s. 429.255, F.S.;

1539

providing that the owner or administrator of an assisted

1540

living facility is responsible for the services provided

1541

in the facility; amending s. 429.26, F.S.; clarifying a

1542

prohibition on moving a resident; providing for the

1543

development of a service plan for all residents; requiring

1544

a criminal records check to be conducted on all residents

1545

of an assisted living facility; requiring residents to be

1546

periodically assessed for competency to handle personal

1547

affairs; amending s. 429.27, F.S.; prohibiting assisted

1548

living facility personnel from making certain decisions

1549

for a resident or act as the resident's representative or

1550

surrogate; amending s. 429.28, F.S.; requiring that notice

1551

of a resident's relocation or termination of residency be

1552

in writing and a copy sent to specified persons; requiring

1553

the agency to compile an annual report for the Governor

1554

and the Legislature; requiring facilities to have a

1555

written grievance procedure that includes certain

1556

information; requiring that grievances reported to the

1557

local ombudsman council be included in a statewide

1558

reporting system; revising provisions relating to agency

1559

surveys to determine compliance with resident rights in

1560

assisted living facilities; amending s. 429.294, F.S.;

1561

deleting a cross-reference; amending s. 429.34, F.S.;

1562

providing for unannounced inspections; providing for

1563

additional 6-month inspections for certain violations;

1564

providing for an additional fine for 6-month inspections;

1565

amending s. 429.41, F.S.; requiring all residents of

1566

assisted living facilities to have a service plan;

1567

amending s. 429.65, F.S.; providing a definition of the

1568

term "Reside"; amending s. 429.67, F.S.; expanding the

1569

list of persons who must have a background screening in

1570

adult family-care homes; amending s. 429.69, F.S.;

1571

providing that the failure of a adult family-care home

1572

provider to live in the home is grounds for the denial,

1573

revocation, or suspension of a license; amending s.

1574

429.73, F.S.; requiring adult family-care home residents

1575

to be periodically assessed for competency to handle

1576

personal affairs; amending ss. 435.03 and 435.04, F.S.;

1577

providing additional criminal offenses for screening

1578

certain health care facility personnel; repealing s.

1579

400.141(13), F.S., relating to a requirement to post

1580

certain information in nursing homes; repealing s.

1581

408.809(3), F.S., relating to the granting of a

1582

provisional license while awaiting the results of a

1583

background screening; repealing s. 429.08(2), F.S.,

1584

deleting a provision relating to local workgroups of field

1585

offices of the Agency for Health Care Administration;

1586

repealing s. 429.41(5), F.S., relating to agency

1587

inspections; amending ss. 430.80 and 651.118, F.S.;

1588

conforming cross-references; providing an effective date.

3/11/2008  2:03:00 PM     CF.CF.04770