1

A bill to be entitled

2

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

3

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

4

Family Services to obtain copies of driver's license files

5

maintained by the Department of Highway Safety and Motor

6

Vehicles for the purpose of conducting protective

7

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

8

criminal records check to be conducted on all nursing home

9

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

10

relating to unannounced inspections; amending s. 400.215,

11

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

12

home to submit to background screening; prohibiting

13

employees and contracted workers who do not meet

14

background screening requirements from being employed in a

15

nursing home; providing certain exceptions; deleting an

16

obsolete provision; amending s. 408.810, F.S.; requiring

17

health care facilities regulated by the Agency for Health

18

Care Administration to post certain information in the

19

facility; amending s. 408.811, F.S.; providing that agency

20

employees who provide advance notice of unannounced agency

21

inspections are subject to suspension; amending s.

22

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

23

abuse hotline relating to vulnerable adults to be

24

immediately transferred to the county sheriff's office;

25

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

26

Children and Family Services to file the petition to

27

determine incapacity in adult protection proceedings;

28

prohibiting the department from serving as the guardian or

29

providing legal counsel to the guardian; amending s.

30

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

31

Department of Children and Family Services relating to

32

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

33

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

34

remove the limitation that plans are required only in

35

assisted living facilities that have an extended

36

congregate care license; amending s. 429.07, F.S.;

37

providing that license requirements for specialty licenses

38

apply to current licensees as well as applicants for an

39

extended congregate care and limited nursing license;

40

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

41

requiring certain employees and contracted workers in

42

assisted living facilities to submit to background

43

screening; prohibiting employees and contracted workers

44

who do not meet background screening requirements from

45

being employed in an assisted living facility; providing

46

certain exceptions; requiring the person being screened to

47

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

48

providing that the owner or administrator of an assisted

49

living facility is responsible for the services provided

50

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

51

prohibition on moving a resident; providing for the

52

development of a service plan for all residents; requiring

53

a criminal records check to be conducted on all residents

54

of an assisted living facility; requiring residents to be

55

periodically assessed for competency to handle personal

56

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

57

living facility personnel from making certain decisions

58

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

59

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

60

of a resident's relocation or termination of residency be

61

in writing and a copy sent to specified persons; requiring

62

the agency to compile an annual report for the Governor

63

and the Legislature; requiring facilities to have a

64

written grievance procedure that includes certain

65

information; requiring that grievances reported to the

66

local ombudsman council be included in a statewide

67

reporting system; revising provisions relating to agency

68

surveys to determine compliance with resident rights in

69

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

70

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

71

providing for unannounced inspections; providing for

72

additional 6-month inspections for certain violations;

73

providing for an additional fine for 6-month inspections;

74

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

75

assisted living facilities to have a service plan;

76

amending s. 429.67, F.S.; expanding the list of persons

77

who must have a background screening in adult family-care

78

homes; amending s. 429.69, F.S.; providing that the

79

failure of a adult family-care home provider to live in

80

the home is grounds for the denial, revocation, or

81

suspension of a license; amending s. 429.73, F.S.;

82

requiring adult family-care home residents to be

83

periodically assessed for competency to handle personal

84

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

85

additional criminal offenses for screening certain health

86

care facility personnel; repealing s. 400.141(13), F.S.,

87

relating to a requirement to post certain information in

88

nursing homes; repealing s. 429.08(2), F.S., deleting a

89

provision relating to local workgroups of field offices of

90

the Agency for Health Care Administration; repealing s.

91

429.19(7), F.S., relating to survey fees charged for

92

complaint investigations of assisted living facilities;

93

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

94

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

95

conforming cross-references; providing an effective date.

96

97

Be It Enacted by the Legislature of the State of Florida:

98

99

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

100

Statutes, is amended to read:

101

     322.142  Color photographic or digital imaged licenses.--

102

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

103

file. The department shall maintain a record of the digital image

104

and signature of the licensees, together with other data required

105

by the department for identification and retrieval. Reproductions

106

from the file or digital record are exempt from the provisions of

107

s. 119.07(1) and shall be made and issued only for departmental

108

administrative purposes; for the issuance of duplicate licenses;

109

in response to law enforcement agency requests; to the Department

110

of State pursuant to an interagency agreement to facilitate

111

determinations of eligibility of voter registration applicants

112

and registered voters in accordance with ss. 98.045 and 98.075;

113

to the Department of Revenue pursuant to an interagency agreement

114

for use in establishing paternity and establishing, modifying, or

115

enforcing support obligations in Title IV-D cases; to the

116

Department of Children and Family Services pursuant to an

117

interagency agreement to conduct protective investigations under

118

chapter 415; or to the Department of Financial Services pursuant

119

to an interagency agreement to facilitate the location of owners

120

of unclaimed property, the validation of unclaimed property

121

claims, and the identification of fraudulent or false claims, and

122

are exempt from the provisions of s. 119.07(1).

123

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

124

Florida Statutes, to read:

125

     400.141  Administration and management of nursing home

126

facilities.--Every licensed facility shall comply with all

127

applicable standards and rules of the agency and shall:

128

     (25) Conduct a criminal records background check of a

129

prospective resident before admission or immediately after

130

admission at the resident's expense. The information obtained may

131

be used by the facility to assess the needs of the resident and

132

to provide adequate and appropriate health care and protective

133

and support services in accordance with this part.

134

135

Facilities that have been awarded a Gold Seal under the program

136

established in s. 400.235 may develop a plan to provide certified

137

nursing assistant training as prescribed by federal regulations

138

and state rules and may apply to the agency for approval of their

139

program.

140

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

141

Statutes, is amended to read:

142

     400.19  Right of entry and inspection.--

143

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

144

unannounced inspection to determine compliance by the licensee

145

with statutes, and related with rules promulgated under the

146

provisions of those statutes, governing minimum standards of

147

construction, quality and adequacy of care, and rights of

148

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

149

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

150

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

151

arising from separate surveys or investigations within a 60-day

152

period, or has had three or more substantiated complaints within

153

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

154

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

155

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

156

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

157

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

158

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

159

Consumer Price Index, based on the 12 months immediately

160

preceding the change increase, to cover the cost of the

161

additional surveys. The agency shall verify through subsequent

162

inspection that any deficiency identified during inspection is

163

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

164

class III or class IV deficiency unrelated to resident rights or

165

resident care without reinspecting the facility if adequate

166

written documentation has been received from the facility, which

167

provides assurance that the deficiency has been corrected. The

168

giving or causing to be given of advance notice of such

169

unannounced inspections by an employee of the agency to any

170

unauthorized person shall constitute cause for suspension of not

171

fewer than 5 working days according to the provisions of chapter

172

110.

173

     Section 4.  Section 400.215, Florida Statutes, is amended to

174

read:

175

     400.215 Background Personnel screening requirement.--

176

     (1) The agency shall require Background screening as

177

provided in chapter 435 is required for all nursing home facility

178

employees and contracted workers or prospective employees of

179

facilities licensed under this part who are expected to, or whose

180

responsibilities may require them to:

181

     (a)  Provide personal care or services to residents;

182

     (b)  Have access to resident living areas; or

183

     (c)  Have access to resident funds or other personal

184

property.

185

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

186

workers shall comply with the requirements of s. 435.05.

187

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

188

facilities must have in their possession evidence that level 1

189

screening under s. 435.03 has been completed before allowing an

190

employee or contracted worker to begin employment in the facility

191

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

192

information necessary for conducting level 1 background screening

193

using level 1 standards as specified in s. 435.03 shall be

194

submitted by the nursing facility to the agency. Results of the

195

background screening shall be provided by the agency to the

196

requesting nursing facility.

197

     (b) Employees and contracted workers qualified under the

198

provisions of paragraph (a) who have not maintained continuous

199

residency within the state for the 5 years immediately preceding

200

the date of request for background screening must complete level

201

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

202

may work in a conditional status for up to 180 days pending the

203

receipt of written findings evidencing the completion of level 2

204

screening. Contracted workers who are awaiting the completion of

205

level 2 screening may work only under the direct and visual

206

supervision of persons who have met the screening requirements of

207

this section. Level 2 screening is shall not be required for of

208

employees, or prospective employees, or contracted workers who

209

attest in writing under penalty of perjury that they meet the

210

residency requirement. To complete Completion of level 2

211

screening: shall require

212

     1. The employee or contracted worker shall prospective

213

employee to furnish to the nursing facility a full set of

214

fingerprints for conducting a federal criminal records check to

215

enable a criminal background investigation to be conducted.

216

     2. The nursing facility shall submit the completed

217

fingerprint card to the agency.

218

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

219

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

220

request to the Department of Law Enforcement, which is authorized

221

to submit the fingerprints to the Federal Bureau of Investigation

222

for a national criminal history records check.

223

     4. The results of the national criminal history records

224

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

225

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

226

     5. The agency shall notify the administrator of the

227

requesting nursing facility or the administrator of any other

228

requesting facility licensed under chapter 393, chapter 394,

229

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

230

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

231

qualified under level 1 or level 2 screening.

232

233

An employee or contracted worker prospective employee who has

234

qualified under level 2 screening and has maintained such

235

continuous residency within the state is shall not be required to

236

complete a subsequent level 2 screening as a condition of

237

employment at another facility.

238

     (c) The agency shall establish and maintain a database that

239

includes of background screening information which shall include

240

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

241

Department of Law Enforcement shall timely provide to the agency,

242

electronically, the results of each statewide screening for

243

incorporation into the database. The agency shall, upon request

244

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

245

by law to screen its employees or contracted workers applicants,

246

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

247

the qualifying or disqualifying status of the person employee or

248

applicant named in the request.

249

     (d) Applicants and Employees, prospective employees, and

250

contracted workers shall be excluded from employment pursuant to

251

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

252

exempted or all appeals have been resolved in favor of the person

253

screened.

254

     (3) The person being screened applicant is responsible for

255

paying the fees associated with obtaining the required screening.

256

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

257

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

258

level 1 and level 2 screening. Facilities may reimburse employees

259

or contracted workers for these costs. The Department of Law

260

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

261

screening a rate sufficient to cover the costs of such screening

262

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

263

reimburse nursing facilities for the cost of conducting

264

background screening as required by this section. This

265

reimbursement is will not be subject to any rate ceilings or

266

payment targets in the Medicaid Reimbursement plan.

267

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

268

     (a) The agency may grant an exemption from disqualification

269

to an employee, or prospective employee, or contracted worker who

270

is subject to this section and who has not received a

271

professional license or certification from the Department of

272

Health.

273

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

274

board within the Department of Health, or that department itself

275

when there is no board, may grant an exemption from

276

disqualification to an employee, or prospective employee, or

277

contracted worker who is subject to this section and who has

278

received a professional license or certification from the

279

Department of Health or a regulatory board within that

280

department.

281

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

282

Persons who have been screened and qualified as required by this

283

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

284

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

285

having been convicted of a disqualifying offense since the

286

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

287

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

288

written verification of qualifying screening results from the

289

previous employer, contractor, or other entity that which caused

290

the such screening to be performed.

291

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

292

authority to adopt rules to administer pursuant to the

293

Administrative Procedure Act to implement this section.

294

     (7) All employees shall comply with the requirements of

295

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

296

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

297

to submit to rescreening if the nursing facility has in its

298

possession written evidence that the person has been screened and

299

qualified according to level 1 standards as specified in s.

300

435.03(1). Any current employee who meets the level 1 requirement

301

but does not meet the 5-year residency requirement as specified

302

in this section must provide to the employing nursing facility

303

written attestation under penalty of perjury that the employee

304

has not been convicted of a disqualifying offense in another

305

state or jurisdiction. All applicants hired on or after October

306

1, 1998, shall comply with the requirements of this section.

307

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

308

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

309

arising against, an employer that, upon notice of a disqualifying

310

offense listed under chapter 435 or an act of domestic violence,

311

terminates the employee against whom the report was issued,

312

whether or not the employee has filed for an exemption with the

313

Department of Health or the agency for Health Care

314

Administration.

315

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

316

Statutes, is amended to read:

317

     408.810  Minimum licensure requirements.--In addition to the

318

licensure requirements specified in this part, authorizing

319

statutes, and applicable rules, each applicant and licensee must

320

comply with the requirements of this section in order to obtain

321

and maintain a license.

322

     (5) Each licensee must:

323

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

324

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

325

immediate family or representative, if appropriate, of the right

326

to report:

327

     1.  Complaints. The statewide toll-free telephone number for

328

reporting complaints to the agency must be provided to clients in

329

a manner that is clearly legible and must include the words: "To

330

report a complaint regarding the services you receive, please

331

call toll-free (phone number)."

332

     2.  Abusive, neglectful, or exploitative practices. The

333

statewide toll-free telephone number for the central abuse

334

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

335

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

336

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

337

shall publish a minimum of a 90-day advance notice of a change in

338

the toll-free telephone numbers.

339

     (b) Each licensee shall Establish appropriate policies and

340

procedures for providing such notice to clients.

341

     (c) Publicly display a poster provided by the agency

342

containing the names, addresses, and telephone numbers for the

343

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

344

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

345

Persons with Disabilities, the Florida Statewide Advocacy

346

Council, the Medicaid Fraud Control Unit, and the Statewide

347

Public Guardianship Office, along with a clear description of the

348

assistance to be expected from each.

349

     Section 6.  Paragraph (a) of subsection (1) of section

350

408.811, Florida Statutes, is amended to read:

351

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

352

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

353

make or cause to be made any inspection or investigation deemed

354

necessary by the agency to determine the state of compliance with

355

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

356

of inspection extends to any business that the agency has reason

357

to believe is being operated as a provider without a license, but

358

inspection of any business suspected of being operated without

359

the appropriate license may not be made without the permission of

360

the owner or person in charge unless a warrant is first obtained

361

from a circuit court. Any application for a license issued under

362

this part, authorizing statutes, or applicable rules constitutes

363

permission for an appropriate inspection to verify the

364

information submitted on or in connection with the application.

365

     (a)  All inspections shall be unannounced, except as

366

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

367

advance notice of the unannounced inspection by an agency

368

employee to any unauthorized person shall, in accordance with

369

chapter 110, constitute cause for suspension of the employee for

370

at least 5 working days.

371

     Section 7.  Subsection (2) of section 415.103, Florida

372

Statutes, is amended to read:

373

     415.103  Central abuse hotline.--

374

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

375

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

376

the central abuse hotline shall must determine if the report

377

requires an immediate onsite protective investigation.

378

     (a) For reports requiring an immediate onsite protective

379

investigation, the central abuse hotline must immediately notify

380

the department's designated protective investigative district

381

staff responsible for protective investigations to ensure prompt

382

initiation of an onsite investigation.

383

     (b) For reports not requiring an immediate onsite

384

protective investigation, the central abuse hotline must notify

385

the department's designated protective investigative district

386

staff responsible for protective investigations in sufficient

387

time to allow for an investigation to be commenced within 24

388

hours. At the time of notification of district staff with respect

389

to the report, the central abuse hotline must also provide any

390

known information on any previous reports report concerning the a

391

subject of the present report or any pertinent information

392

relative to the present report or any noted earlier reports.

393

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

394

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

395

household member, the call shall be immediately transferred to

396

the appropriate county sheriff's office.

397

     Section 8.  Paragraph (e) of subsection (1) and paragraph

398

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

399

amended to read:

400

     415.1051  Protective services interventions when capacity to

401

consent is lacking; nonemergencies; emergencies; orders;

402

limitations.--

403

     (1)  NONEMERGENCY PROTECTIVE SERVICES INTERVENTIONS.--If the

404

department has reasonable cause to believe that a vulnerable

405

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

406

neglected, or exploited and is in need of protective services but

407

lacks the capacity to consent to protective services, the

408

department shall petition the court for an order authorizing the

409

provision of protective services.

410

     (e)  Continued protective services.--

411

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

412

authorizing the provision of protective services, the department

413

shall petition the court to determine whether:

414

     a. Protective services are to will be continued with the

415

consent of the vulnerable adult pursuant to this subsection;

416

     b. Protective services are to will be continued for the

417

vulnerable adult who lacks capacity;

418

     c. Protective services are to will be discontinued; or

419

     d. A petition for guardianship shall should be filed

420

pursuant to chapter 744.

421

     2.  If the court determines that a petition for guardianship

422

shall should be filed pursuant to chapter 744, the court, for

423

good cause shown, may order continued protective services until

424

it makes a determination regarding capacity.

425

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

426

vulnerable adult lacks capacity, the petition to determine

427

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

428

the petition is filed, the department may not be appointed

429

guardian and may not provide legal counsel for the guardian.

430

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

431

department has reasonable cause to believe that a vulnerable

432

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

433

death or serious physical injury to the vulnerable adult and that

434

the vulnerable adult lacks the capacity to consent to emergency

435

protective services, the department may take action under this

436

subsection. If the vulnerable adult has the capacity to consent

437

and refuses consent to emergency protective services, emergency

438

protective services may not be provided.

439

     (g)  Continued emergency protective services.--

440

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

441

authorizing the provision of emergency protective services, the

442

department shall petition the court to determine whether:

443

     a. Emergency protective services are to will be continued

444

with the consent of the vulnerable adult;

445

     b. Emergency protective services are to will be continued

446

for the vulnerable adult who lacks capacity;

447

     c. Emergency protective services are to will be

448

discontinued; or

449

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

450

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

451

for good cause shown, the court may order continued emergency

452

protective services until a determination is made by the court.

453

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

454

vulnerable adult lacks capacity, the petition to determine

455

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

456

the petition is filed, the department may not be appointed

457

guardian and may not provide legal counsel for the guardian.

458

     Section 9.  Section 415.112, Florida Statutes, is amended to

459

read:

460

     415.112 Rules for implementation of ss. 415.101-

461

415.113.--The department shall adopt promulgate rules to

462

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

463

implementation of ss. 415.101-415.113.

464

     (1) Background screening of department employees and

465

employee applicants which includes a criminal records check and

466

drug testing of adult protective investigators and adult

467

protective investigator supervisors.

468

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

469

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

470

protective investigations.

471

     (3) Confidentiality and retention of department records,

472

access to records, and record requests.

473

     (4) Injunctions and other protective orders.

474

     (5) The provision of emergency and nonemergency protective

475

services intervention.

476

     (6) Agreements with law enforcement and other state

477

agencies.

478

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

479

limited to, diligent search, petitions, emergency removals,

480

capacity to consent, and adult protection teams.

481

     (8) The legal and casework management of cases involving

482

protective supervision, protective orders, judicial reviews,

483

administrative reviews, case plans, and documentation

484

requirements.

485

     Section 10.  Subsection (21) of section 429.02, Florida

486

Statutes, is amended to read:

487

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

488

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

489

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

490

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

491

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

492

representing the facility, which addresses the unique physical

493

and psychosocial needs, abilities, and personal preferences of

494

each resident receiving extended congregate care services. The

495

plan must shall include a brief written description, in easily

496

understood language, of what services shall be provided, who

497

shall provide the services, when the services shall be rendered,

498

and the purposes and benefits of the services.

499

     Section 11.  Paragraphs (b) and (c) of subsection (3) of

500

section 429.07, Florida Statutes, are amended to read:

501

     429.07  License required; fee.--

502

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

503

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

504

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

505

more of the following categories of care: standard, extended

506

congregate care, limited nursing services, or limited mental

507

health.

508

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

509

facilities providing, directly or through contract, services

510

beyond those authorized in paragraph (a), including services

511

performed by persons licensed under acts performed pursuant to

512

part I of chapter 464 by persons licensed thereunder, and

513

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

514

otherwise would be disqualified from continued residence in a

515

facility licensed under this part.

516

     1. To obtain an In order for extended congregate care

517

license services to be provided in a facility licensed under this

518

part, the agency must first determine that all requirements

519

established in law and rule are met and must specifically

520

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

521

provided and whether the designation applies to all or part of

522

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

523

initial licensure or relicensure, or upon request in writing by a

524

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

525

of approval or denial of the such request shall be made in

526

accordance with part II of chapter 408. Existing

527

     2. Facilities applying for, and facilities currently

528

licensed qualifying to provide, extended congregate care services

529

must have maintained a standard license and may not have been

530

subject to administrative sanctions during the previous 2 years,

531

or since initial licensure if the facility has been licensed for

532

less than 2 years, for any of the following reasons:

533

     a.  A class I or class II violation;

534

     b.  Three or more repeat or recurring class III violations

535

of identical or similar resident care standards as specified in

536

rule from which a pattern of noncompliance is found by the

537

agency;

538

     c.  Three or more class III violations that were not

539

corrected in accordance with the corrective action plan approved

540

by the agency;

541

     d. Violation of resident care standards which result in

542

requiring the facility resulting in a requirement to employ the

543

services of a consultant pharmacist or consultant dietitian;

544

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

545

another facility licensed under this part in which the applicant

546

for an extended congregate care license has at least 25 percent

547

ownership interest; or

548

     f.  Imposition of a moratorium pursuant to this part or part

549

II of chapter 408 or initiation of injunctive proceedings.

550

     3.2. A facility that is Facilities that are licensed to

551

provide extended congregate care services must shall maintain a

552

written progress report on each person who receives such

553

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

554

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

555

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

556

appropriate designee, representing the agency shall visit the

557

facility such facilities at least quarterly to monitor residents

558

who are receiving extended congregate care services and to

559

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

560

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

561

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

562

survey. The monitoring visits may be provided through contractual

563

arrangements with appropriate community agencies. A registered

564

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

565

facility. The agency may waive one of the required yearly

566

monitoring visits for a facility that has been licensed for at

567

least 24 months to provide extended congregate care services, if,

568

during the inspection, the registered nurse determines that

569

extended congregate care services are being provided

570

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

571

violations and no uncorrected class III violations. Before such

572

decision is made, The agency must first shall consult with the

573

long-term care ombudsman council for the area in which the

574

facility is located to determine if any complaints have been made

575

and substantiated about the quality of services or care. The

576

agency may not waive one of the required yearly monitoring visits

577

if complaints have been made and substantiated.

578

     4.3. Facilities that are licensed to provide extended

579

congregate care services must shall:

580

     a.  Demonstrate the capability to meet unanticipated

581

resident service needs.

582

     b.  Offer a physical environment that promotes a homelike

583

setting, provides for resident privacy, promotes resident

584

independence, and allows sufficient congregate space as defined

585

by rule.

586

     c.  Have sufficient staff available, taking into account the

587

physical plant and firesafety features of the building, to assist

588

with the evacuation of residents in an emergency, as necessary.

589

     d.  Adopt and follow policies and procedures that maximize

590

resident independence, dignity, choice, and decisionmaking to

591

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

592

moves due to changes in functional status are minimized or

593

avoided.

594

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

595

representative, designee, surrogate, guardian, or attorney in

596

fact to make a variety of personal choices, participate in

597

developing service plans, and share responsibility in

598

decisionmaking.

599

     f.  Implement the concept of managed risk.

600

     g. Provide, either directly or through contract, the

601

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

602

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

603

provide specialized training as defined by rule for facility

604

staff.

605

     5.4. Facilities licensed to provide extended congregate

606

care services are exempt from the criteria for continued

607

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

608

Facilities so licensed must shall adopt their own requirements

609

within guidelines for continued residency set forth by rule.

610

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

611

hour nursing supervision. Facilities licensed to provide extended

612

congregate care services must shall provide each resident with a

613

written copy of facility policies governing admission and

614

retention.

615

     6.5. The primary purpose of extended congregate care

616

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

617

option of remaining in a familiar setting from which they would

618

otherwise be disqualified for continued residency. A facility

619

licensed to provide extended congregate care services may also

620

admit an individual who exceeds the admission criteria for a

621

facility with a standard license, if the individual is determined

622

appropriate for admission to the extended congregate care

623

facility.

624

     7.6. Before admission of an individual to a facility

625

licensed to provide extended congregate care services, the

626

individual must undergo a medical examination as provided in s.

627

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

628

plan for the individual as provided in s. 429.26.

629

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

630

services in accordance with the resident's service plan and needs

631

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

632

for relocating the person in accordance with s. 429.28(1)(k).

633

     9.8. Failure to provide extended congregate care services

634

may result in denial of extended congregate care license renewal.

635

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

636

consultation with the agency, shall prepare and submit to the

637

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

638

of Representatives, and the chairs of appropriate legislative

639

committees, a report on the status of, and recommendations

640

related to, extended congregate care services. The status report

641

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

642

information:

643

     a. A description of the facilities licensed to provide such

644

services, including total number of beds licensed under this

645

part.

646

     b. The number and characteristics of residents receiving

647

such services.

648

     c. The types of services rendered that could not be

649

provided through a standard license.

650

     d. An analysis of deficiencies cited during licensure

651

inspections.

652

     e. The number of residents who required extended congregate

653

care services at admission and the source of admission.

654

     f. Recommendations for statutory or regulatory changes.

655

     g. The availability of extended congregate care to state

656

clients residing in facilities licensed under this part and in

657

need of additional services, and recommendations for

658

appropriations to subsidize extended congregate care services for

659

such persons.

660

     h. Such other information as the department considers

661

appropriate.

662

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

663

facility that provides services beyond those authorized in

664

paragraph (a) and as specified in this paragraph.

665

     1. To obtain a In order for limited nursing services

666

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

667

the agency must first determine that all requirements established

668

in law and rule are met and must specifically designate, on the

669

facility's license, that such services may be provided. Such

670

designation may be made at the time of initial licensure or

671

relicensure, or upon request in writing by a licensee under this

672

part and part II of chapter 408. Notification of approval or

673

denial of such request shall be made in accordance with part II

674

of chapter 408. Existing

675

     2. Facilities applying for, and facilities currently

676

licensed qualifying to provide, limited nursing services must

677

shall have maintained a standard license and may not have been

678

subject to administrative sanctions that affect the health,

679

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

680

since initial licensure if the facility has been licensed for

681

less than 2 years.

682

     3.2. Facilities that are licensed to provide limited

683

nursing services shall maintain a written progress report on each

684

person who receives such nursing services, which report describes

685

the type, amount, duration, scope, and outcome of services that

686

are rendered and the general status of the resident's health. A

687

registered nurse representing the agency shall visit such

688

facilities at least twice a year to monitor residents who are

689

receiving limited nursing services and to determine if the

690

facility is in compliance with applicable provisions of this

691

part, part II of chapter 408, and related rules. The monitoring

692

visits may be provided through contractual arrangements with

693

appropriate community agencies. A registered nurse shall also

694

serve as part of the team that inspects the such facility.

695

     4.3. A person who receives limited nursing services under

696

this part must meet the admission criteria established by the

697

agency for assisted living facilities. If When a resident no

698

longer meets the admission criteria for a facility licensed under

699

this part, arrangements for relocating the person shall be made

700

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

701

licensed to provide extended congregate care services.

702

     Section 12.  Section 429.174, Florida Statutes, is amended

703

to read:

704

     429.174  Background screening; exemptions.--The owner or

705

administrator of an assisted living facility must conduct level 1

706

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

707

employees and contracted workers hired on or after October 1,

708

1998, who perform personal services or who have access to

709

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

710

exempt an individual from employment disqualification as set

711

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

712

employed or resume employment pending the granting of an

713

exemption or until all appeals have been resolved in favor of the

714

person screened. Employees and contracted workers Such persons

715

shall be considered as having met the screening requirements this

716

requirement if:

717

     (1) Proof of compliance with level 1 screening requirements

718

obtained to meet any professional license requirements in this

719

state is provided and accompanied, under penalty of perjury, by a

720

copy of the person's current professional license and an

721

affidavit of current compliance with the background screening

722

requirements.

723

     (2)  The person required to be screened has been

724

continuously employed in the same type of occupation for which

725

the person is seeking employment without a breach in service

726

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

727

screening requirement which is no more than 2 years old is

728

provided. Proof of compliance shall be provided directly from one

729

employer or contractor to another, and not from the person

730

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

731

provided by the employer or contractor retaining documentation of

732

the screening to the person screened.

733

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

734

contracts with a corporation or business entity or related

735

corporation or business entity that owns, operates, or manages

736

more than one facility or agency licensed under this chapter, and

737

for whom a level 1 screening was conducted by the corporation or

738

business entity as a condition of initial or continued

739

employment.

740

     (4) The person being screened is responsible for paying the

741

fees associated with obtaining the required screening. Payment

742

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

743

shall establish a schedule of fees to cover the costs of level 1

744

and level 2 screening. Facilities may reimburse employees or

745

contracted workers for these costs. The Department of Law

746

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

747

screening a rate sufficient to cover the costs of screening

748

pursuant to s. 943.053(3).

749

     Section 13.  Subsection (1) of section 429.255, Florida

750

Statutes, is amended to read:

751

     429.255  Use of personnel; emergency care.--

752

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

753

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

754

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

755

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

756

administer medications to residents, take residents' vital signs,

757

manage individual weekly pill organizers for residents who self-

758

administer medication, give prepackaged enemas ordered by a

759

physician, observe residents, document observations on the

760

appropriate resident's record, report observations to the

761

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

762

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

763

attorney in fact to contract with a third party, provided

764

residents meet the criteria for appropriate placement as defined

765

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

766

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

767

licensed nurse or physician.

768

     (b) Facility All staff, including persons under contract to

769

the facility, facility employees, and volunteers in facilities

770

licensed under this part shall exercise their professional

771

responsibility to observe residents, to document observations on

772

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

773

to the resident's physician, and to provide needed services

774

competently. However, the owner or administrator of the facility

775

is shall be responsible for determining that the resident

776

receiving services is appropriate for residence in the facility

777

and for the provision of and quality of care and services

778

provided to the resident.

779

     (c)  In an emergency situation, licensed personnel may carry

780

out their professional duties pursuant to part I of chapter 464

781

until emergency medical personnel assume responsibility for care.

782

     Section 14.  Present subsections (8) through (12) of section

783

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

784

(10), respectively, and present subsections (1) through (7) of

785

that section, are amended to read:

786

     429.26  Appropriateness of placements; examinations of

787

residents.--

788

     (1)  The owner or administrator of a facility is responsible

789

for determining the appropriateness of admission of an individual

790

to the facility and for determining the continued appropriateness

791

of residence of an individual in the facility. A determination

792

shall be based upon an assessment of the strengths, needs, and

793

preferences of the resident, the care and services offered or

794

arranged for by the facility in accordance with facility policy,

795

and any limitations in law or rule related to admission criteria

796

or continued residency for the type of license held by the

797

facility under this part. Except as provided in s. 429.28(1)(k),

798

a resident may not be moved from one facility to another without

799

consultation with and agreement from the resident or, if

800

applicable, the resident's representative or designee or the

801

resident's family, guardian, surrogate, or attorney in fact. If

802

In the case of a resident who has been placed by the department

803

or the Department of Children and Family Services, the

804

administrator must notify the appropriate contact person in the

805

applicable department.

806

     (2) A physician, physician assistant, or nurse practitioner

807

who is employed by an assisted living facility to provide an

808

initial examination for admission purposes may not have financial

809

interest in the facility.

810

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

811

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

812

basis or at least monthly, perform a nursing assessment of the

813

residents for whom they are providing nursing services ordered by

814

a physician, except administration of medication, and shall

815

document such assessment, including any substantial changes in a

816

resident's status which may necessitate relocation to a nursing

817

home, hospital, or specialized health care facility. Such records

818

shall be maintained in the facility for inspection by the agency

819

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

820

applicable.

821

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

822

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

823

licensed nurse practitioner within 60 days before admission to

824

the facility. The person conducting an examination under this

825

subsection may not have financial interest in the facility. The

826

signed and completed medical examination report shall be

827

submitted to the owner or administrator of the facility who shall

828

use the information contained in the report therein to assist in

829

determining the determination of the appropriateness of the

830

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

831

develop a service plan for the resident. The medical examination

832

report and service plan shall become a permanent part of the

833

record of the resident at the facility and shall be made

834

available to the agency during inspection or upon request. An

835

assessment that has been completed through the Comprehensive

836

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

837

fulfills the requirements for a medical examination under this

838

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

839

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

840

examination has not been completed within 60 days before the

841

admission of the resident to the facility, medical personnel a

842

licensed physician, licensed physician assistant, or licensed

843

nurse practitioner shall examine the resident and complete a

844

medical examination form provided by the agency within 30 days

845

following the admission to the facility to enable the facility

846

owner or administrator to determine the appropriateness of the

847

admission. The medical examination form shall become a permanent

848

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

849

made available to the agency during inspection by the agency or

850

upon request.

851

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

852

the department or the Department of Children and Family Services

853

must be shall have been examined by medical personnel within 30

854

days before placement in the facility and recorded on a medical

855

examination form provided by the agency. The examination shall

856

include an assessment of the appropriateness of placement in a

857

facility. The findings of this examination shall be recorded on

858

the examination form provided by the agency. The completed form

859

shall accompany the resident and shall be submitted to the

860

facility owner or administrator. For Additionally, in the case of

861

a mental health resident, the Department of Children and Family

862

Services must provide documentation that the individual has been

863

assessed by a psychiatrist, clinical psychologist, clinical

864

social worker, or psychiatric nurse, or an individual who is

865

supervised by one of these professionals, and determined to be

866

appropriate to reside in an assisted living facility. The

867

documentation must be in the facility within 30 days after the

868

mental health resident has been admitted to the facility. An

869

evaluation completed upon discharge from a state mental hospital

870

meets the requirements of this subsection related to

871

appropriateness for placement as a mental health resident

872

providing it was completed within 90 days prior to admission to

873

the facility. The applicable department shall provide to the

874

facility administrator any information about the resident that

875

would help the administrator meet his or her responsibilities

876

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

877

shall explain to the facility operator any special needs of the

878

resident and advise the operator whom to call should problems

879

arise. The applicable department shall advise and assist the

880

facility administrator where the special needs of residents who

881

are recipients of optional state supplementation require such

882

assistance.

883

     (3) A criminal records background check of a prospective

884

resident must be conducted by the facility before admission or

885

immediately after admission at the resident's expense. The

886

information obtained may be used by the facility to assess the

887

needs of the resident and the care and services offered or

888

arranged by the facility in accordance with this section.

889

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

890

employed by or under contract with a facility shall at least

891

monthly, perform a nursing assessment of residents for whom they

892

are providing nursing services ordered by a physician, except

893

administration of medication, and shall document such assessment,

894

including any substantial change in a resident's status which may

895

necessitate relocation to a nursing home, hospital, or

896

specialized health care facility. The records must be maintained

897

in the facility for inspection by the agency and shall be

898

forwarded to the resident's case manager, if 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 designee,

903

guardian, surrogate, or attorney in fact is available to make

904

decisions on behalf of the resident. The facility must notify a

905

licensed physician when a resident exhibits signs of dementia or

906

cognitive impairment or has a change of condition in order to

907

rule out the presence of an underlying physiological condition

908

that may be contributing to such dementia or impairment. The

909

notification must occur within 30 days after the acknowledgment

910

of such signs by facility staff. If an underlying condition is

911

determined to exist, the facility shall arrange, with the

912

appropriate health care provider, the necessary care and services

913

to treat the condition.

914

     Section 15.  Subsections (3) through (8) of section 429.27,

915

Florida Statutes, are renumbered as subsections (6) through (11),

916

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

917

amended to read:

918

     429.27  Property and personal affairs of residents.--

919

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

920

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

921

roommate; and, whenever possible, unless the resident is

922

adjudicated incompetent or incapacitated under state law,

923

managing his or her own affairs.

924

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

925

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

926

its owner, administrator, staff employees, or representatives any

927

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

928

resident or to make financial or health care decisions on behalf

929

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

930

any of such persons any authority or responsibility for the

931

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

932

necessary for the safe management of the facility or for the

933

safety of the resident.

934

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

935

employee, or representative thereof, may not act as the

936

resident's representative or designee, guardian, health care

937

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

938

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

939

unless the person is a relative of the resident.

940

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

941

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

942

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

943

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

944

administrator, or staff, or representative thereof who, serves as

945

representative payee for a any resident must of the facility

946

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

947

twice the average monthly aggregate income or personal funds due

948

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

949

are received by a facility.

950

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

951

representative thereof who, is granted power of attorney for a

952

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

953

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

954

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

955

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

956

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

957

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

958

principal and a licensed surety company. The bond shall be

959

conditioned upon the faithful compliance of the facility with

960

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

961

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

962

or misappropriation by a facility of funds held pursuant to this

963

subsection. Any surety company that cancels or does not renew the

964

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

965

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

966

cancellation or nonrenewal. Any facility owner, administrator, or

967

staff, or representative thereof, who is granted power of

968

attorney for a any resident of the facility shall, on a monthly

969

basis, be required to provide the resident with a written

970

statement of any transaction made on behalf of the resident

971

pursuant to this subsection, and a copy of such statement given

972

to the resident shall be retained in each resident's file and

973

available for agency inspection.

974

     Section 16.  Paragraphs (k) and (l) of subsection (1) and

975

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

976

to read:

977

     429.28  Resident bill of rights.--

978

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

979

civil or legal rights, benefits, or privileges guaranteed by law,

980

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

981

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

982

a facility shall have the right to:

983

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

984

termination of residency from the facility unless, for medical

985

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

986

emergency relocation to a facility providing a more skilled level

987

of care or the resident engages in a pattern of conduct that is

988

harmful or offensive to other residents. The notice must specify

989

the reasons for the relocation or termination and a copy of the

990

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

991

representative or designee, guardian, surrogate, attorney in

992

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

993

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

994

compile an annual report summarizing the information received in

995

the notice, including the number and reasons for relocation or

996

termination of facility residents, type and size of facilities,

997

and other information that the agency considers relevant, which

998

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

999

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

1000

resident who has been adjudicated mentally incapacitated, the

1001

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

1002

nonemergency relocation or residency termination. Reasons for

1003

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

1004

to terminate the residency of an individual without notice as

1005

provided in this paragraph herein, the facility must shall show

1006

good cause in a court of competent jurisdiction.

1007

     (l)  Present grievances and recommend changes in policies,

1008

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

1009

officials, or any other person without restraint, interference,

1010

coercion, discrimination, or reprisal. Each facility shall

1011

establish a written grievance procedure to facilitate the

1012

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

1013

minimum, maintaining a written record of each grievance, the

1014

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

1015

and reporting each grievance within 3 days after receiving the

1016

grievance to the local ombudsman council. The local ombudsman

1017

council shall maintain a record of all grievances received from

1018

each facility in the local area which shall be submitted by the

1019

local council to the Office of the State Long-Term Care Ombudsman

1020

pursuant to s. 400.0089. This right also includes access to

1021

ombudsman volunteers and advocates and the right to be a member

1022

of, to be active in, and to associate with advocacy or special

1023

interest groups.

1024

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

1025

general compliance with facility standards and compliance with

1026

residents' rights as a prerequisite to initial licensure or

1027

licensure renewal.

1028

     (b) In order to determine whether the facility is

1029

adequately protecting residents' rights, the agency's biennial

1030

survey shall include private informal conversations with a sample

1031

of residents and consultation with the ombudsman council in the

1032

planning and service area in which the facility is located to

1033

discuss residents' experiences within the facility.

1034

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

1035

conducted, the agency shall conduct at least one monitoring visit

1036

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

1037

class II violation, or more than three uncorrected class III

1038

violations.

1039

     (d) The agency may conduct periodic followup inspections as

1040

necessary to monitor the compliance of facilities with a history

1041

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

1042

the health, safety, or security of residents.

1043

     (e) The agency may conduct complaint investigations as

1044

warranted to investigate any allegations of noncompliance with

1045

requirements required under this part or rules adopted under this

1046

part.

1047

     Section 17.  Subsection (1) of section 429.294, Florida

1048

Statutes, is amended to read:

1049

     429.294  Availability of facility records for investigation

1050

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

1051

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

1052

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

1053

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

1054

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

1055

400.145, shall constitute evidence of failure of that party to

1056

comply with good faith discovery requirements and shall waive the

1057

good faith certificate and presuit notice requirements under this

1058

part by the requesting party.

1059

     Section 18.  Section 429.34, Florida Statutes, is amended to

1060

read:

1061

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

1062

requirements of s. 408.811:,

1063

     (1) Any duly designated officer or employee of the

1064

department, the Department of Children and Family Services, the

1065

Medicaid Fraud Control Unit of the Office of the Attorney

1066

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

1067

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

1068

right to enter unannounced upon and into the premises of any

1069

facility licensed pursuant to this part in order to determine the

1070

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

1071

chapter 408, and applicable rules. Data collected by the state or

1072

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

1073

advocacy councils may be used by the agency in investigations

1074

involving violations of regulatory standards.

1075

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

1076

unannounced inspection to determine compliance with this chapter

1077

and related rules governing minimum standards of construction and

1078

maintenance, the quality and adequacy of care, and the rights of

1079

residents. Two additional surveys shall be conducted every 6

1080

months for the next year if the facility has been cited for a

1081

class I deficiency or two or more class II deficiencies arising

1082

from separate surveys or investigations within a 60-day period.

1083

In addition to any fines imposed on a facility under s. 429.19,

1084

the agency shall assess a fine of $160 per bed for each of the

1085

additional two surveys. The agency shall adjust this fine by the

1086

change in the Consumer Price Index, based on the 12 months

1087

immediately preceding the change, to cover the cost of the

1088

additional two surveys. The agency shall verify through

1089

subsequent inspections that any deficiency identified during an

1090

inspection is corrected. However, the agency may verify the

1091

correction of a class III or class IV deficiency unrelated to

1092

resident rights or resident care without reinspecting the

1093

facility if adequate written documentation has been received from

1094

the facility which provides assurance that the deficiency has

1095

been corrected.

1096

     Section 19.  Paragraphs (k) and (l) of subsection (1) of

1097

section 429.41, Florida Statutes, are redesignated as paragraphs

1098

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

1099

that subsection, to read:

1100

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

1101

published and enforced pursuant to this section shall include

1102

criteria by which a reasonable and consistent quality of resident

1103

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

1104

resident care may be demonstrated. Such rules shall also ensure a

1105

safe and sanitary environment that is residential and

1106

noninstitutional in design or nature. It is further intended that

1107

reasonable efforts be made to accommodate the needs and

1108

preferences of residents to enhance the quality of life in a

1109

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

1110

adopt rules to administer the requirements of part II of chapter

1111

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

1112

highest quality of resident care accommodating the needs and

1113

preferences of residents, the department, in consultation with

1114

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

1115

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

1116

procedures to administer this part, which must include reasonable

1117

and fair minimum standards in relation to:

1118

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

1119

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

1120

for a resident receiving nursing services ordered by a physician,

1121

except administration of medication, the plan must be reviewed

1122

and updated quarterly.

1123

     Section 20.  Subsection (4) of section 429.67, Florida

1124

Statutes, is amended to read:

1125

     429.67  Licensure.--

1126

     (4)  Upon receipt of a completed license application or

1127

license renewal, and the fee, the agency shall initiate a level 1

1128

background screening as provided under chapter 435 on the adult

1129

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

1130

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

1131

person who provides personal services to residents or who have

1132

access to the adult family-care home.

1133

     (a)  Proof of compliance with level 1 screening standards

1134

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

1135

facility or professional licensure requirements of the agency or

1136

the Department of Health satisfies the requirements of this

1137

subsection. Such proof must be accompanied, under penalty of

1138

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

1139

and an affidavit of current compliance with the background

1140

screening requirements.

1141

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

1142

continuously employed in the same type of occupation for which

1143

the person is seeking employment without a breach in service that

1144

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

1145

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

1146

provided. Proof of compliance shall be provided directly from one

1147

employer or contractor to another, and not from the person

1148

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

1149

provided to the person screened by the employer retaining

1150

documentation of the screening.

1151

     Section 21.  Subsection (3) is added to section 429.69,

1152

Florida Statutes, to read:

1153

     429.69  Denial, revocation, and suspension of a license.--In

1154

addition to the requirements of part II of chapter 408, the

1155

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

1156

following reasons:

1157

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

1158

or rents the home to live in the home.

1159

     Section 22.  Paragraph (b) of subsection (1) of section

1160

429.73, Florida Statutes, is amended to read:

1161

     429.73  Rules and standards relating to adult family-care

1162

homes.--

1163

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

1164

adopt rules to administer the requirements of part II of chapter

1165

408. The department, in consultation with the Department of

1166

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

1167

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

1168

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

1169

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

1170

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

1171

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

1172

must include, but need not be limited to:

1173

     1.  Room and board.

1174

     2.  Assistance necessary to perform the activities of daily

1175

living.

1176

     3.  Assistance necessary to administer medication.

1177

     4.  Supervision of residents.

1178

     5. Health monitoring, including periodic assessments to

1179

determine if the resident is competent to handle his or her

1180

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

1181

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

1182

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

1183

     6.  Social and leisure activities.

1184

     Section 23.  Subsections (2) and (3) of section 435.03,

1185

Florida Statutes, are amended to read:

1186

     435.03  Level 1 screening standards.--

1187

     (2)  Any person for whom employment screening is required by

1188

statute must not have been convicted of found guilty of,

1189

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

1190

contendere or guilty to, regardless of adjudication, to any

1191

offense prohibited under any of the following provisions of the

1192

Florida statutes or under any similar statute of another

1193

jurisdiction:

1194

     (a)  Section 393.135, relating to sexual misconduct with

1195

certain developmentally disabled clients and reporting of such

1196

sexual misconduct.

1197

     (b)  Section 394.4593, relating to sexual misconduct with

1198

certain mental health patients and reporting of such sexual

1199

misconduct.

1200

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

1201

exploitation of a vulnerable adult.

1202

     (d)  Section 782.04, relating to murder.

1203

     (e)  Section 782.07, relating to manslaughter, aggravated

1204

manslaughter of an elderly person or disabled adult, or

1205

aggravated manslaughter of a child.

1206

     (f)  Section 782.071, relating to vehicular homicide.

1207

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

1208

child by injury to the mother.

1209

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

1210

the offense was a minor.

1211

     (i)  Section 784.021, relating to aggravated assault.

1212

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

1213

the offense was a minor.

1214

     (k)  Section 784.045, relating to aggravated battery.

1215

     (l)  Section 787.01, relating to kidnapping.

1216

     (m)  Section 787.02, relating to false imprisonment.

1217

     (n)  Section 794.011, relating to sexual battery.

1218

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

1219

persons in familial or custodial authority.

1220

     (p)  Chapter 796, relating to prostitution.

1221

     (q)  Section 798.02, relating to lewd and lascivious

1222

behavior.

1223

     (r)  Chapter 800, relating to lewdness and indecent

1224

exposure.

1225

     (s)  Section 806.01, relating to arson.

1226

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

1227

crimes, if the offense was a felony.

1228

     (u)  Section 817.563, relating to fraudulent sale of

1229

controlled substances, only if the offense was a felony.

1230

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

1231

or neglect of an elderly person or disabled adult.

1232

     (w)  Section 825.1025, relating to lewd or lascivious

1233

offenses committed upon or in the presence of an elderly person

1234

or disabled adult.

1235

     (x)  Section 825.103, relating to exploitation of an elderly

1236

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

1237

     (y)  Section 826.04, relating to incest.

1238

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

1239

child abuse, or neglect of a child.

1240

     (aa)  Section 827.04, relating to contributing to the

1241

delinquency or dependency of a child.

1242

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

1243

children.

1244

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

1245

child.

1246

     (dd)  Chapter 847, relating to obscene literature.

1247

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

1248

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

1249

involved in the offense was a minor.

1250

     (ff)  Section 916.1075, relating to sexual misconduct with

1251

certain forensic clients and reporting of such sexual misconduct.

1252

     (3)  Standards must also ensure that the person:

1253

     (a)  For employees and employers licensed or registered

1254

pursuant to chapter 400 or chapter 429, and for employees and

1255

employers of developmental disabilities institutions as defined

1256

in s. 393.063, intermediate care facilities for the

1257

developmentally disabled as defined in s. 400.960, and mental

1258

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

1259

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

1260

contendere, regardless of adjudication, to offenses prohibited

1261

under any of the following statutes or under any similar statute

1262

of another jurisdiction: meets the requirements of this chapter.

1263

     1. Sections 409.920 and 409.9201, relating to Medicaid

1264

fraud.

1265

     2. Chapter 429, relating to assisted care communities.

1266

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

1267

negligence, if the offense is a felony.

1268

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

1269

a felony.

1270

     5. Section 817.034, relating to communications fraud.

1271

     6. Section 817.234, relating to fraudulent insurance

1272

claims.

1273

     7. Section 817.505, relating to patient brokering.

1274

     8. Section 817.568, relating to identification theft.

1275

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

1276

the offense is a felony.

1277

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

1278

831.31 relating to forgery, uttering, and counterfeiting.

1279

     (b)  Has not committed an act that constitutes domestic

1280

violence as defined in s. 741.28.

1281

     Section 24.  Subsections (2) and (4) of section 435.04,

1282

Florida Statutes, are amended to read:

1283

     435.04  Level 2 screening standards.--

1284

     (2)  The security background investigations under this

1285

section must ensure that no persons subject to the provisions of

1286

this section have been convicted found guilty of, regardless of

1287

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

1288

guilty to, regardless of adjudication, to any offense prohibited

1289

under any of the following provisions of the Florida statutes or

1290

under any similar statute of another jurisdiction:

1291

     (a)  Section 393.135, relating to sexual misconduct with

1292

certain developmentally disabled clients and reporting of such

1293

sexual misconduct.

1294

     (b)  Section 394.4593, relating to sexual misconduct with

1295

certain mental health patients and reporting of such sexual

1296

misconduct.

1297

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

1298

exploitation of aged persons or disabled adults.

1299

     (d)  Section 782.04, relating to murder.

1300

     (e)  Section 782.07, relating to manslaughter, aggravated

1301

manslaughter of an elderly person or disabled adult, or

1302

aggravated manslaughter of a child.

1303

     (f)  Section 782.071, relating to vehicular homicide.

1304

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

1305

child by injury to the mother.

1306

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

1307

the offense was a minor.

1308

     (i)  Section 784.021, relating to aggravated assault.

1309

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

1310

the offense was a minor.

1311

     (k)  Section 784.045, relating to aggravated battery.

1312

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

1313

commitment facility staff.

1314

     (m)  Section 787.01, relating to kidnapping.

1315

     (n)  Section 787.02, relating to false imprisonment.

1316

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

1317

removing a child beyond the state limits with criminal intent

1318

pending custody proceedings.

1319

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

1320

the state lines with criminal intent to avoid producing a child

1321

at a custody hearing or delivering the child to the designated

1322

person.

1323

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

1324

weapons within 1,000 feet of a school.

1325

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

1326

electric weapon or device, destructive device, or other weapon on

1327

school property.

1328

     (s)  Section 794.011, relating to sexual battery.

1329

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

1330

persons in familial or custodial authority.

1331

     (u)  Chapter 796, relating to prostitution.

1332

     (v)  Section 798.02, relating to lewd and lascivious

1333

behavior.

1334

     (w)  Chapter 800, relating to lewdness and indecent

1335

exposure.

1336

     (x)  Section 806.01, relating to arson.

1337

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

1338

crimes, if the offense is a felony.

1339

     (z)  Section 817.563, relating to fraudulent sale of

1340

controlled substances, only if the offense was a felony.

1341

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

1342

or neglect of an elderly person or disabled adult.

1343

     (bb)  Section 825.1025, relating to lewd or lascivious

1344

offenses committed upon or in the presence of an elderly person

1345

or disabled adult.

1346

     (cc)  Section 825.103, relating to exploitation of an

1347

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

1348

     (dd)  Section 826.04, relating to incest.

1349

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

1350

child abuse, or neglect of a child.

1351

     (ff)  Section 827.04, relating to contributing to the

1352

delinquency or dependency of a child.

1353

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

1354

children.

1355

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

1356

child.

1357

     (ii)  Section 843.01, relating to resisting arrest with

1358

violence.

1359

     (jj)  Section 843.025, relating to depriving a law

1360

enforcement, correctional, or correctional probation officer

1361

means of protection or communication.

1362

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

1363

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

1364

juvenile inmates in correctional institutions.

1365

     (mm)  Chapter 847, relating to obscene literature.

1366

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

1367

recruiting another to join a criminal gang.

1368

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

1369

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

1370

involved in the offense was a minor.

1371

     (pp)  Section 916.1075, relating to sexual misconduct with

1372

certain forensic clients and reporting of such sexual misconduct.

1373

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

1374

inhuman treatment on an inmate resulting in great bodily harm.

1375

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

1376

aiding an escaped prisoner.

1377

     (ss)  Section 944.47, relating to introduction of contraband

1378

into a correctional facility.

1379

     (tt)  Section 985.701, relating to sexual misconduct in

1380

juvenile justice programs.

1381

     (uu)  Section 985.711, relating to contraband introduced

1382

into detention facilities.

1383

     (4)  Standards must also ensure that the person:

1384

     (a)  For employees or employers licensed or registered

1385

pursuant to chapter 400 or chapter 429, and for employees and

1386

employers of developmental disabilities institutions as defined

1387

in s. 393.063, intermediate care facilities for the

1388

developmentally disabled as defined in s. 400.960, and mental

1389

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

1390

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

1391

contendere, regardless of adjudication, to offenses prohibited

1392

under any of the following statutes or under similar statutes of

1393

another jurisdiction: does not have a confirmed report of abuse,

1394

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

1395

been uncontested or upheld under s. 415.103.

1396

     1. Sections 409.920 and 409.9201, relating to Medicaid

1397

fraud.

1398

     2. Chapter 429, relating to assisted care communities.

1399

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

1400

negligence, if the offense is a felony.

1401

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

1402

a felony.

1403

     5. Section 817.034, relating to communications fraud.

1404

     6. Section 817.234, relating to fraudulent insurance

1405

claims.

1406

     7. Section 817.505, relating to patient brokering.

1407

     8. Section 817.568, relating to identification theft.

1408

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

1409

the offense is a felony.

1410

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

1411

831.31 relating to forgery, uttering, and counterfeiting.

1412

     (b)  Has not committed an act that constitutes domestic

1413

violence as defined in s. 741.28 s. 741.30.

1414

     Section 25. Subsection (13) of section 400.141, subsection

1415

(2) of section 429.08, subsection (7) of section 429.19, and

1416

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

1417

     Section 26.  Paragraph (h) of subsection (3) of section

1418

430.80, Florida Statutes, is amended to read:

1419

     430.80  Implementation of a teaching nursing home pilot

1420

project.--

1421

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

1422

home licensee must, at a minimum:

1423

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

1424

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

1425

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

1426

include:

1427

     1.  Maintaining an escrow account consisting of cash or

1428

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

1429

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

1430

unexpired, irrevocable, nontransferable and nonassignable letter

1431

of credit issued by a any bank or savings association organized

1432

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

1433

savings association organized under the laws of the United States

1434

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

1435

branch office which is authorized to receive deposits in this

1436

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

1437

obligation of the facility to the claimant upon presentment of a

1438

final judgment indicating liability and awarding damages to be

1439

paid by the facility or upon presentment of a settlement

1440

agreement signed by all parties if the to the agreement when such

1441

final judgment or settlement is a result of a liability claim

1442

against the facility.

1443

     Section 27.  Subsection (13) of section 651.118, Florida

1444

Statutes, is amended to read:

1445

     651.118  Agency for Health Care Administration; certificates

1446

of need; sheltered beds; community beds.--

1447

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

1448

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

1449

400.141(15)(d).

1450

     Section 28.  This act shall take effect July 1, 2008.