HB 1387

1	A bill to be entitled
2	An act relating to the inspection of nursing homes;
3	amending ss. 381.006, 381.0072, 381.0098, and 465.017,
4	F.S.; providing that nursing homes that are inspected by
5	the Agency for Health Care Administration are exempt from
6	inspection by the Department of Health; repealing s.
7	400.0060(1), F.S., to delete the definition of
8	"administrative assessment"; amending ss. 400.0061 and
9	400.0075, F.S.; conforming provisions to changes made by
10	the act relating to onsite administrative assessments;
11	amending s. 400.0065, F.S.; clarifying that any person may
12	make a complaint against a long-term care facility,
13	including an employee of that facility; amending ss.
14	400.0067, 400.0069, and 400.0071, F.S.; conforming
15	provisions to changes made by the act relating to onsite
16	administrative assessments; clarifying that any person may
17	make a complaint against a long-term care facility,
18	including an employee of that facility; repealing s.
19	400.0074, F.S., relating to onsite administrative
20	assessments of nursing homes, assisted living facilities,
21	and adult family-care homes conducted by the local
22	ombudsman council; amending s. 400.121, F.S.; conforming
23	provisions to changes made by the act relating to
24	classifications of deficiencies; amending ss. 400.071 and
25	400.141, F.S.; conforming provisions to changes made by
26	the act relating to classifications of deficiencies and
27	the Gold Seal Program; amending s. 400.19, F.S.;
28	conforming provisions to changes made by the act relating
29	to classifications of deficiencies; repealing s. 400.191,
30	F.S., relating to a requirement that the agency make
31	available to the public, distribute, and post reports and
32	records concerning licensed nursing homes operating in the
33	state; amending s. 400.195, F.S.; revising agency
34	reporting requirements; amending s. 400.23, F.S.;
35	conforming provisions to changes made by the act relating
36	to the Gold Seal Program and availability of certain
37	reports and records; revising the classifications for
38	deficiencies; revising agency standards for evaluation of
39	a nursing home facility to determine licensure status;
40	requiring the agency to indicate the level of seriousness
41	of deficiencies under certain provisions of the United
42	States Code; repealing s. 400.235, F.S., relating to
43	nursing home quality and licensure status and the Gold
44	Seal Program; amending s. 408.035, F.S.; conforming a
45	provision to changes made by the act relating to the Gold
46	Seal Program; repealing s. 408.036(3)(k), F.S., relating
47	to projects exempt from review for a certificate of need,
48	to remove an exemption for the addition of nursing home
49	beds in certain facilities, including Gold Seal Program
50	facilities; repealing s. 409.912(15)(d), F.S., relating to
51	the requirement by the staff of the Comprehensive
52	Assessment and Review for Long-Term Services to conduct an
53	assessment and review of a sample of individuals whose
54	nursing home stays are expected to exceed a certain number
55	of days; amending s. 633.081, F.S.; providing that nursing
56	homes that are inspected by the agency are exempt from
57	inspection by the State Fire Marshal under certain
58	circumstances; providing an effective date.
59
60	Be It Enacted by the Legislature of the State of Florida:
61
62	Section 1.  Subsection (16) of section 381.006, Florida
63	Statutes, is amended to read:
64	381.006  Environmental health.--The department shall
65	conduct an environmental health program as part of fulfilling
66	the state's public health mission. The purpose of this program
67	is to detect and prevent disease caused by natural and manmade
68	factors in the environment. The environmental health program
69	shall include, but not be limited to:
70	(16)  A group-care-facilities function, where a group care
71	facility means any public or private school, housing, building
72	or buildings, section of a building, or distinct part of a
73	building or other place, whether operated for profit or not,
74	which undertakes, through its ownership or management, to
75	provide one or more personal services, care, protection, and
76	supervision to persons who require such services and who are not
77	related to the owner or administrator. The department may adopt
78	rules necessary to protect the health and safety of residents,
79	staff, and patrons of group care facilities, such as child care
80	facilities, family day care homes, assisted living facilities,
81	adult day care centers, adult family care homes, hospices,
82	residential treatment facilities, crisis stabilization units,
83	pediatric extended care centers, intermediate care facilities
84	for the developmentally disabled, group care homes, and, jointly
85	with the Department of Education, private and public schools.
86	These rules may include definitions of terms; provisions
87	relating to operation and maintenance of facilities, buildings,
88	grounds, equipment, furnishings, and occupant-space
89	requirements; lighting; heating, cooling, and ventilation; food
90	service; water supply and plumbing; sewage; sanitary facilities;
91	insect and rodent control; garbage; safety; personnel health,
92	hygiene, and work practices; and other matters the department
93	finds are appropriate or necessary to protect the safety and
94	health of the residents, staff, or patrons. The department may
95	not adopt rules that conflict with rules adopted by the
96	licensing or certifying agency. The department may enter and
97	inspect at reasonable hours to determine compliance with
98	applicable statutes or rules. However, nursing homes that are
99	licensed under part II of chapter 400 and inspected by the
100	Agency for Health Care Administration as part of state licensing
101	requirements and federal certification requirements are exempt
102	from inspection by the department. In addition to any sanctions
103	that the department may impose for violations of rules adopted
104	under this section, the department shall also report such
105	violations to any agency responsible for licensing or certifying
106	the group care facility. The licensing or certifying agency may
107	also impose any sanction based solely on the findings of the
108	department.
109
110	The department may adopt rules to carry out the provisions of
111	this section.
112	Section 2.  Paragraph (a) of subsection (2) of section
113	381.0072, Florida Statutes, is amended to read:
114	381.0072  Food service protection.--It shall be the duty of
115	the Department of Health to adopt and enforce sanitation rules
116	consistent with law to ensure the protection of the public from
117	food-borne illness. These rules shall provide the standards and
118	requirements for the storage, preparation, serving, or display
119	of food in food service establishments as defined in this
120	section and which are not permitted or licensed under chapter
121	500 or chapter 509.
122	(2)  DUTIES.--
123	(a)  The department shall adopt rules, including
124	definitions of terms which are consistent with law prescribing
125	minimum sanitation standards and manager certification
126	requirements as prescribed in s. 509.039, and which shall be
127	enforced in food service establishments as defined in this
128	section. The sanitation standards must address the construction,
129	operation, and maintenance of the establishment; lighting,
130	ventilation, laundry rooms, lockers, use and storage of toxic
131	materials and cleaning compounds, and first-aid supplies; plan
132	review; design, construction, installation, location,
133	maintenance, sanitation, and storage of food equipment and
134	utensils; employee training, health, hygiene, and work
135	practices; food supplies, preparation, storage, transportation,
136	and service, including access to the areas where food is stored
137	or prepared; and sanitary facilities and controls, including
138	water supply and sewage disposal; plumbing and toilet
139	facilities; garbage and refuse collection, storage, and
140	disposal; and vermin control. Public and private schools, if the
141	food service is operated by school employees; hospitals licensed
142	under chapter 395; nursing homes licensed under part II of
143	chapter 400; child care facilities as defined in s. 402.301;
144	residential facilities colocated with a nursing home or
145	hospital, if all food is prepared in a central kitchen that
146	complies with nursing or hospital regulations; and bars and
147	lounges, as defined by department rule, are exempt from the
148	rules developed for manager certification. The department shall
149	administer a comprehensive inspection, monitoring, and sampling
150	program to ensure such standards are maintained; however,
151	nursing homes that are licensed under part II of chapter 400 and
152	inspected by the Agency for Health Care Administration as part
153	of state licensing requirements and federal certification
154	requirements are exempt from inspection by the department. With
155	respect to food service establishments permitted or licensed
156	under chapter 500 or chapter 509, the department shall assist
157	the Division of Hotels and Restaurants of the Department of
158	Business and Professional Regulation and the Department of
159	Agriculture and Consumer Services with rulemaking by providing
160	technical information.
161	Section 3.  Paragraph (b) of subsection (6) of section
162	381.0098, Florida Statutes, is amended to read:
163	381.0098  Biomedical waste.--
164	(6)  TRACKING SYSTEM.--The department shall adopt rules for
165	a system of tracking biomedical waste.
166	(b)  Inspections may be conducted for purposes of
167	compliance with this section. Any such inspection shall be
168	commenced and completed with reasonable promptness. However,
169	nursing homes that are licensed under part II of chapter 400 and
170	inspected by the Agency for Health Care Administration as part
171	of state licensing requirements and federal certification
172	requirements are exempt from inspection by the department. If
173	the officer, employee, or representative of the department
174	obtains any samples, prior to leaving the premises he or she
175	shall give the owner, operator, or agent in charge a receipt
176	describing the sample obtained.
177	Section 4.  Subsection (1) of section 400.0060, Florida
178	Statutes, is repealed.
179	Section 5.  Subsection (2) of section 400.0061, Florida
180	Statutes, is amended to read:
181	400.0061  Legislative findings and intent; long-term care
182	facilities.--
183	(2)  It is the intent of the Legislature, therefore, to
184	utilize voluntary citizen ombudsman councils under the
185	leadership of the ombudsman, and through them to operate an
186	ombudsman program which shall, without interference by any
187	executive agency, undertake to discover, investigate, and
188	determine the presence of conditions or individuals which
189	constitute a threat to the rights, health, safety, or welfare of
190	the residents of long-term care facilities. To ensure that the
191	effectiveness and efficiency of such investigations are not
192	impeded by advance notice or delay, the Legislature intends that
193	the ombudsman and ombudsman councils and their designated
194	representatives not be required to obtain warrants in order to
195	enter into or conduct investigations or onsite administrative
196	assessments of long-term care facilities. It is the further
197	intent of the Legislature that the environment in long-term care
198	facilities be conducive to the dignity and independence of
199	residents and that investigations by ombudsman councils shall
200	further the enforcement of laws, rules, and regulations that
201	safeguard the health, safety, and welfare of residents.
202	Section 6.  Paragraph (a) of subsection (1) of section
203	400.0065, Florida Statutes, is amended to read:
204	400.0065  State Long-Term Care Ombudsman; duties and
205	responsibilities.--
206	(1)  The purpose of the Office of State Long-Term Care
207	Ombudsman shall be to:
208	(a)  Identify, investigate, and resolve complaints made by
209	or on behalf of residents of long-term care facilities,
210	regardless of the person who makes the complaint, including an
211	employee of the long-term care facility, relating to actions or
212	omissions by providers or representatives of providers of long-
213	term care services, other public or private agencies, guardians,
214	or representative payees which that may adversely affect the
215	health, safety, welfare, or rights of the residents.
216	Section 7.  Paragraphs (b) and (d) of subsection (2) of
217	section 400.0067, Florida Statutes, are amended to read:
218	400.0067  State Long-Term Care Ombudsman Council; duties;
219	membership.--
220	(2)  The State Long-Term Care Ombudsman Council shall:
221	(b)  Serve as an appellate body in receiving from the local
222	councils complaints not resolved at the local level. Any
223	individual member or members of the state council may enter any
224	long-term care facility involved in an appeal, pursuant to the
225	conditions specified in s. 400.0074(2).
226	(d)  Assist the ombudsman in eliciting, receiving,
227	responding to, and resolving complaints made by or on behalf of
228	residents regardless of the person who makes the complaint,
229	including an employee of a long-term care facility.
230	Section 8.  Paragraph (c) of subsection (2) and subsection
231	(3) of section 400.0069, Florida Statutes, are amended to read:
232	400.0069  Local long-term care ombudsman councils; duties;
233	membership.--
234	(2)  The duties of the local councils are to:
235	(c)  Elicit, receive, investigate, respond to, and resolve
236	complaints made by or on behalf of residents regardless of the
237	person who makes the complaint, including an employee of a long-
238	term care facility.
239	(3)  In order to carry out the duties specified in
240	subsection (2), a member of a local council is authorized to
241	enter any long-term care facility without notice or first
242	obtaining a warrant, subject to the provisions of s.
243	400.0074(2).
244	Section 9.  Section 400.0071, Florida Statutes, is amended
245	to read:
246	400.0071  State Long-Term Care Ombudsman Program complaint
247	procedures.--The department shall adopt rules implementing state
248	and local complaint procedures. The rules must include
249	procedures for:
250	(1)  Receiving complaints against a long-term care facility
251	or an employee of a long-term care facility regardless of the
252	person who makes the complaint.
253	(2)  Conducting investigations of a long-term care facility
254	or an employee of a long-term care facility subsequent to
255	receiving a complaint.
256	(3)  Conducting onsite administrative assessments of long-
257	term care facilities.
258	Section 10.  Section 400.0074, Florida Statutes, is
259	repealed.
260	Section 11.  Paragraph (a) of subsection (1) of section
261	400.0075, Florida Statutes, is amended to read:
262	400.0075  Complaint notification and resolution
263	procedures.--
264	(1)(a)  Any complaint or problem verified by an ombudsman
265	council as a result of an investigation or onsite administrative
266	assessment, which complaint or problem is determined to require
267	remedial action by the local council, shall be identified and
268	brought to the attention of the long-term care facility
269	administrator in writing. Upon receipt of such document, the
270	administrator, with the concurrence of the local council chair,
271	shall establish target dates for taking appropriate remedial
272	action. If, by the target date, the remedial action is not
273	completed or forthcoming, the local council chair may, after
274	obtaining approval from the ombudsman and a majority of the
275	members of the local council:
276	1.  Extend the target date if the chair has reason to
277	believe such action would facilitate the resolution of the
278	complaint.
279	2.  In accordance with s. 400.0077, publicize the
280	complaint, the recommendations of the council, and the response
281	of the long-term care facility.
282	3.  Refer the complaint to the state council.
283	Section 12.  Subsections (3), (4), and (5) of section
284	400.071, Florida Statutes, are amended to read:
285	400.071  Application for license.--
286	(3)  It is the intent of the Legislature that, in reviewing
287	a certificate-of-need application to add beds to an existing
288	nursing home facility, preference be given to the application of
289	a licensee who has been awarded a Gold Seal as provided for in
290	s. 400.235, if the applicant otherwise meets the review criteria
291	specified in s. 408.035.
292	(3)(4)  The agency may develop an abbreviated survey for
293	licensure renewal applicable to a licensee that has continuously
294	operated as a nursing facility since 1991 or earlier, has
295	operated under the same management for at least the preceding 30
296	months, and has had during the preceding 30 months no immediate
297	jeopardy or actual harm that is not immediate jeopardy class I
298	or class II deficiencies.
299	(4)(5)  As a condition of licensure, each facility must
300	establish and submit with its application a plan for quality
301	assurance and for conducting risk management.
302	Section 13.  Subsection (3) of section 400.121, Florida
303	Statutes, is amended to read:
304	400.121  Denial, suspension, revocation of license;
305	administrative fines; procedure; order to increase staffing.--
306	(3)  The agency shall revoke or deny a nursing home license
307	if the licensee or controlling interest operates a facility in
308	this state that:
309	(a)  Has had two moratoria issued pursuant to this part or
310	part II of chapter 408 which are imposed by final order for
311	substandard quality of care, as defined by 42 C.F.R. part 483,
312	within any 30-month period;
313	(b)  Is conditionally licensed for 180 or more continuous
314	days;
315	(c)  Is cited for two immediate jeopardy class I
316	deficiencies arising from unrelated circumstances during the
317	same survey or investigation; or
318	(d)  Is cited for two immediate jeopardy class I
319	deficiencies arising from separate surveys or investigations
320	within a 30-month period.
321
322	The licensee may present factors in mitigation of revocation,
323	and the agency may make a determination not to revoke a license
324	based upon a showing that revocation is inappropriate under the
325	circumstances.
326	Section 14.  Section 400.141, Florida Statutes, is amended
327	to read:
328	400.141  Administration and management of nursing home
329	facilities.--Every licensed facility shall comply with all
330	applicable standards and rules of the agency and shall:
331	(1)  Be under the administrative direction and charge of a
332	licensed administrator.
333	(2)  Appoint a medical director licensed pursuant to
334	chapter 458 or chapter 459. The agency may establish by rule
335	more specific criteria for the appointment of a medical
336	director.
337	(3)  Have available the regular, consultative, and
338	emergency services of physicians licensed by the state.
339	(4)  Provide for resident use of a community pharmacy as
340	specified in s. 400.022(1)(q). Any other law to the contrary
341	notwithstanding, a registered pharmacist licensed in Florida,
342	that is under contract with a facility licensed under this
343	chapter or chapter 429, shall repackage a nursing facility
344	resident's bulk prescription medication which has been packaged
345	by another pharmacist licensed in any state in the United States
346	into a unit dose system compatible with the system used by the
347	nursing facility, if the pharmacist is requested to offer such
348	service. In order to be eligible for the repackaging, a resident
349	or the resident's spouse must receive prescription medication
350	benefits provided through a former employer as part of his or
351	her retirement benefits, a qualified pension plan as specified
352	in s. 4972 of the Internal Revenue Code, a federal retirement
353	program as specified under 5 C.F.R. s. 831, or a long-term care
354	policy as defined in s. 627.9404(1). A pharmacist who correctly
355	repackages and relabels the medication and the nursing facility
356	which correctly administers such repackaged medication under the
357	provisions of this subsection shall not be held liable in any
358	civil or administrative action arising from the repackaging. In
359	order to be eligible for the repackaging, a nursing facility
360	resident for whom the medication is to be repackaged shall sign
361	an informed consent form provided by the facility which includes
362	an explanation of the repackaging process and which notifies the
363	resident of the immunities from liability provided herein. A
364	pharmacist who repackages and relabels prescription medications,
365	as authorized under this subsection, may charge a reasonable fee
366	for costs resulting from the implementation of this provision.
367	(5)  Provide for the access of the facility residents to
368	dental and other health-related services, recreational services,
369	rehabilitative services, and social work services appropriate to
370	their needs and conditions and not directly furnished by the
371	licensee. When a geriatric outpatient nurse clinic is conducted
372	in accordance with rules adopted by the agency, outpatients
373	attending such clinic shall not be counted as part of the
374	general resident population of the nursing home facility, nor
375	shall the nursing staff of the geriatric outpatient clinic be
376	counted as part of the nursing staff of the facility, until the
377	outpatient clinic load exceeds 15 a day.
378	(6)  Be allowed and encouraged by the agency to provide
379	other needed services under certain conditions. If the facility
380	has a standard licensure status, and has had no immediate
381	jeopardy or actual harm that is not immediate jeopardy class I
382	or class II deficiencies during the past 2 years or has been
383	awarded a Gold Seal under the program established in s. 400.235,
384	it may be encouraged by the agency to provide services,
385	including, but not limited to, respite and adult day services,
386	which enable individuals to move in and out of the facility. A
387	facility is not subject to any additional licensure requirements
388	for providing these services. Respite care may be offered to
389	persons in need of short-term or temporary nursing home
390	services. Respite care must be provided in accordance with this
391	part and rules adopted by the agency. However, the agency shall,
392	by rule, adopt modified requirements for resident assessment,
393	resident care plans, resident contracts, physician orders, and
394	other provisions, as appropriate, for short-term or temporary
395	nursing home services. The agency shall allow for shared
396	programming and staff in a facility which meets minimum
397	standards and offers services pursuant to this subsection, but,
398	if the facility is cited for deficiencies in patient care, may
399	require additional staff and programs appropriate to the needs
400	of service recipients. A person who receives respite care may
401	not be counted as a resident of the facility for purposes of the
402	facility's licensed capacity unless that person receives 24-hour
403	respite care. A person receiving either respite care for 24
404	hours or longer or adult day services must be included when
405	calculating minimum staffing for the facility. Any costs and
406	revenues generated by a nursing home facility from
407	nonresidential programs or services shall be excluded from the
408	calculations of Medicaid per diems for nursing home
409	institutional care reimbursement.
410	(7)  If the facility has a standard license or is a Gold
411	Seal facility, exceeds the minimum required hours of licensed
412	nursing and certified nursing assistant direct care per resident
413	per day, and is part of a continuing care facility licensed
414	under chapter 651 or a retirement community that offers other
415	services pursuant to part III of this chapter or part I or part
416	III of chapter 429 on a single campus, be allowed to share
417	programming and staff. At the time of inspection and in the
418	semiannual report required pursuant to subsection (15), a
419	continuing care facility or retirement community that uses this
420	option must demonstrate through staffing records that minimum
421	staffing requirements for the facility were met. Licensed nurses
422	and certified nursing assistants who work in the nursing home
423	facility may be used to provide services elsewhere on campus if
424	the facility exceeds the minimum number of direct care hours
425	required per resident per day and the total number of residents
426	receiving direct care services from a licensed nurse or a
427	certified nursing assistant does not cause the facility to
428	violate the staffing ratios required under s. 400.23(3)(a).
429	Compliance with the minimum staffing ratios shall be based on
430	total number of residents receiving direct care services,
431	regardless of where they reside on campus. If the facility
432	receives a conditional license, it may not share staff until the
433	conditional license status ends. This subsection does not
434	restrict the agency's authority under federal or state law to
435	require additional staff if a facility is cited for deficiencies
436	in care which are caused by an insufficient number of certified
437	nursing assistants or licensed nurses. The agency may adopt
438	rules for the documentation necessary to determine compliance
439	with this provision.
440	(8)  Maintain the facility premises and equipment and
441	conduct its operations in a safe and sanitary manner.
442	(9)  If the licensee furnishes food service, provide a
443	wholesome and nourishing diet sufficient to meet generally
444	accepted standards of proper nutrition for its residents and
445	provide such therapeutic diets as may be prescribed by attending
446	physicians. In making rules to implement this subsection, the
447	agency shall be guided by standards recommended by nationally
448	recognized professional groups and associations with knowledge
449	of dietetics.
450	(10)  Keep full records of resident admissions and
451	discharges; medical and general health status, including medical
452	records, personal and social history, and identity and address
453	of next of kin or other persons who may have responsibility for
454	the affairs of the residents; and individual resident care plans
455	including, but not limited to, prescribed services, service
456	frequency and duration, and service goals. The records shall be
457	open to inspection by the agency.
458	(11)  Keep such fiscal records of its operations and
459	conditions as may be necessary to provide information pursuant
460	to this part.
461	(12)  Furnish copies of personnel records for employees
462	affiliated with such facility, to any other facility licensed by
463	this state requesting this information pursuant to this part.
464	Such information contained in the records may include, but is
465	not limited to, disciplinary matters and any reason for
466	termination. Any facility releasing such records pursuant to
467	this part shall be considered to be acting in good faith and may
468	not be held liable for information contained in such records,
469	absent a showing that the facility maliciously falsified such
470	records.
471	(13)  Publicly display a poster provided by the agency
472	containing the names, addresses, and telephone numbers for the
473	state's abuse hotline, the State Long-Term Care Ombudsman, the
474	Agency for Health Care Administration consumer hotline, the
475	Advocacy Center for Persons with Disabilities, the Florida
476	Statewide Advocacy Council, and the Medicaid Fraud Control Unit,
477	with a clear description of the assistance to be expected from
478	each.
479	(14)  Submit to the agency the information specified in s.
480	400.071(1)(b) for a management company within 30 days after the
481	effective date of the management agreement.
482	(15)  Submit semiannually to the agency, or more frequently
483	if requested by the agency, information regarding facility
484	staff-to-resident ratios, staff turnover, and staff stability,
485	including information regarding certified nursing assistants,
486	licensed nurses, the director of nursing, and the facility
487	administrator. For purposes of this reporting:
488	(a)  Staff-to-resident ratios must be reported in the
489	categories specified in s. 400.23(3)(a) and applicable rules.
490	The ratio must be reported as an average for the most recent
491	calendar quarter.
492	(b)  Staff turnover must be reported for the most recent
493	12-month period ending on the last workday of the most recent
494	calendar quarter prior to the date the information is submitted.
495	The turnover rate must be computed quarterly, with the annual
496	rate being the cumulative sum of the quarterly rates. The
497	turnover rate is the total number of terminations or separations
498	experienced during the quarter, excluding any employee
499	terminated during a probationary period of 3 months or less,
500	divided by the total number of staff employed at the end of the
501	period for which the rate is computed, and expressed as a
502	percentage.
503	(c)  The formula for determining staff stability is the
504	total number of employees that have been employed for more than
505	12 months, divided by the total number of employees employed at
506	the end of the most recent calendar quarter, and expressed as a
507	percentage.
508	(d)  A nursing facility that has failed to comply with
509	state minimum-staffing requirements for 2 consecutive days is
510	prohibited from accepting new admissions until the facility has
511	achieved the minimum-staffing requirements for a period of 6
512	consecutive days. For the purposes of this paragraph, any person
513	who was a resident of the facility and was absent from the
514	facility for the purpose of receiving medical care at a separate
515	location or was on a leave of absence is not considered a new
516	admission. Failure to impose such an admissions moratorium
517	constitutes an actual harm that is not immediate jeopardy a
518	class II deficiency.
519	(e)  A nursing facility which does not have a conditional
520	license may be cited for failure to comply with the standards in
521	s. 400.23(3)(a)1.a. only if it has failed to meet those
522	standards on 2 consecutive days or if it has failed to meet at
523	least 97 percent of those standards on any one day.
524	(f)  A facility which has a conditional license must be in
525	compliance with the standards in s. 400.23(3)(a) at all times.
526
527	Nothing in this section shall limit the agency's ability to
528	impose a deficiency or take other actions if a facility does not
529	have enough staff to meet the residents' needs.
530	(16)  Report monthly the number of vacant beds in the
531	facility which are available for resident occupancy on the day
532	the information is reported.
533	(17)  Notify a licensed physician when a resident exhibits
534	signs of dementia or cognitive impairment or has a change of
535	condition in order to rule out the presence of an underlying
536	physiological condition that may be contributing to such
537	dementia or impairment. The notification must occur within 30
538	days after the acknowledgment of such signs by facility staff.
539	If an underlying condition is determined to exist, the facility
540	shall arrange, with the appropriate health care provider, the
541	necessary care and services to treat the condition.
542	(18)  If the facility implements a dining and hospitality
543	attendant program, ensure that the program is developed and
544	implemented under the supervision of the facility director of
545	nursing. A licensed nurse, licensed speech or occupational
546	therapist, or a registered dietitian must conduct training of
547	dining and hospitality attendants. A person employed by a
548	facility as a dining and hospitality attendant must perform
549	tasks under the direct supervision of a licensed nurse.
550	(19)  Report to the agency any filing for bankruptcy
551	protection by the facility or its parent corporation,
552	divestiture or spin-off of its assets, or corporate
553	reorganization within 30 days after the completion of such
554	activity.
555	(20)  Maintain general and professional liability insurance
556	coverage that is in force at all times. In lieu of general and
557	professional liability insurance coverage, a state-designated
558	teaching nursing home and its affiliated assisted living
559	facilities created under s. 430.80 may demonstrate proof of
560	financial responsibility as provided in s. 430.80(3)(h).
561	(21)  Maintain in the medical record for each resident a
562	daily chart of certified nursing assistant services provided to
563	the resident. The certified nursing assistant who is caring for
564	the resident must complete this record by the end of his or her
565	shift. This record must indicate assistance with activities of
566	daily living, assistance with eating, and assistance with
567	drinking, and must record each offering of nutrition and
568	hydration for those residents whose plan of care or assessment
569	indicates a risk for malnutrition or dehydration.
570	(22)  Before November 30 of each year, subject to the
571	availability of an adequate supply of the necessary vaccine,
572	provide for immunizations against influenza viruses to all its
573	consenting residents in accordance with the recommendations of
574	the United States Centers for Disease Control and Prevention,
575	subject to exemptions for medical contraindications and
576	religious or personal beliefs. Subject to these exemptions, any
577	consenting person who becomes a resident of the facility after
578	November 30 but before March 31 of the following year must be
579	immunized within 5 working days after becoming a resident.
580	Immunization shall not be provided to any resident who provides
581	documentation that he or she has been immunized as required by
582	this subsection. This subsection does not prohibit a resident
583	from receiving the immunization from his or her personal
584	physician if he or she so chooses. A resident who chooses to
585	receive the immunization from his or her personal physician
586	shall provide proof of immunization to the facility. The agency
587	may adopt and enforce any rules necessary to comply with or
588	implement this subsection.
589	(23)  Assess all residents for eligibility for pneumococcal
590	polysaccharide vaccination (PPV) and vaccinate residents when
591	indicated within 60 days after the effective date of this act in
592	accordance with the recommendations of the United States Centers
593	for Disease Control and Prevention, subject to exemptions for
594	medical contraindications and religious or personal beliefs.
595	Residents admitted after the effective date of this act shall be
596	assessed within 5 working days of admission and, when indicated,
597	vaccinated within 60 days in accordance with the recommendations
598	of the United States Centers for Disease Control and Prevention,
599	subject to exemptions for medical contraindications and
600	religious or personal beliefs. Immunization shall not be
601	provided to any resident who provides documentation that he or
602	she has been immunized as required by this subsection. This
603	subsection does not prohibit a resident from receiving the
604	immunization from his or her personal physician if he or she so
605	chooses. A resident who chooses to receive the immunization from
606	his or her personal physician shall provide proof of
607	immunization to the facility. The agency may adopt and enforce
608	any rules necessary to comply with or implement this subsection.
609	(24)  Annually encourage and promote to its employees the
610	benefits associated with immunizations against influenza viruses
611	in accordance with the recommendations of the United States
612	Centers for Disease Control and Prevention. The agency may adopt
613	and enforce any rules necessary to comply with or implement this
614	subsection.
615
616	Facilities that have been awarded a Gold Seal under the program
617	established in s. 400.235 may develop a plan to provide
618	certified nursing assistant training as prescribed by federal
619	regulations and state rules and may apply to the agency for
620	approval of their program.
621	Section 15.  Subsection (3) of section 400.19, Florida
622	Statutes, is amended to read:
623	400.19  Right of entry and inspection.--
624	(3)  The agency shall every 15 months conduct at least one
625	unannounced inspection to determine compliance by the licensee
626	with statutes, with federal requirements, and with rules adopted
627	promulgated under the provisions of those statutes and federal
628	requirements, governing minimum standards of construction,
629	quality and adequacy of care, and rights of residents. The
630	survey shall be conducted every 6 months for the next 2-year
631	period if the facility has been cited for an immediate jeopardy
632	a class I deficiency, has been cited for two or more actual harm
633	that is not immediate jeopardy class II deficiencies arising
634	from separate surveys or investigations within a 60-day period,
635	or has had three or more substantiated complaints within a 6-
636	month period, each resulting in at least one immediate jeopardy
637	or actual harm that is not immediate jeopardy class I or class
638	II deficiency. In addition to any other fees or fines in this
639	part, the agency shall assess a fine for each facility that is
640	subject to the 6-month survey cycle. The fine for the 2-year
641	period shall be $6,000, one-half to be paid at the completion of
642	each survey. The agency may adjust this fine by the change in
643	the Consumer Price Index, based on the 12 months immediately
644	preceding the increase, to cover the cost of the additional
645	surveys. The agency shall verify through subsequent inspection
646	that any deficiency identified during inspection is corrected.
647	However, the agency may verify the correction of a class III or
648	class IV deficiency with no actual harm and with or without the
649	potential for minimal harm that is unrelated to resident rights
650	or resident care without reinspecting the facility if adequate
651	written documentation has been received from the facility, which
652	provides assurance that the deficiency has been corrected. The
653	giving or causing to be given of advance notice of such
654	unannounced inspections by an employee of the agency to any
655	unauthorized person shall constitute cause for suspension of not
656	fewer than 5 working days according to the provisions of chapter
657	110.
658	Section 16.  Section 400.191, Florida Statutes, is
659	repealed.
660	Section 17.  Paragraph (d) of subsection (1) of section
661	400.195, Florida Statutes, is amended to read:
662	400.195  Agency reporting requirements.--
663	(1)  For the period beginning June 30, 2001, and ending
664	June 30, 2005, the Agency for Health Care Administration shall
665	provide a report to the Governor, the President of the Senate,
666	and the Speaker of the House of Representatives with respect to
667	nursing homes. The first report shall be submitted no later than
668	December 30, 2002, and subsequent reports shall be submitted
669	every 6 months thereafter. The report shall identify facilities
670	based on their ownership characteristics, size, business
671	structure, for-profit or not-for-profit status, and any other
672	characteristics the agency determines useful in analyzing the
673	varied segments of the nursing home industry and shall report:
674	(d)  Information regarding deficiencies cited, including
675	information used to develop the Nursing Home Guide WATCH LIST
676	pursuant to s. 400.191, and applicable rules, a summary of data
677	generated on nursing homes by Centers for Medicare and Medicaid
678	Services Nursing Home Quality Information Project, and
679	information collected pursuant to s. 400.147(9), relating to
680	litigation.
681	Section 18.  Subsections (2), (7), and (8) of section
682	400.23, Florida Statutes, are amended to read:
683	400.23  Rules; evaluation and deficiencies; licensure
684	status.--
685	(2)  Pursuant to the intention of the Legislature, the
686	agency, in consultation with the Department of Health and the
687	Department of Elderly Affairs, shall adopt and enforce rules to
688	implement this part and part II of chapter 408, which shall
689	include reasonable and fair criteria in relation to:
690	(a)  The location of the facility and housing conditions
691	that will ensure the health, safety, and comfort of residents,
692	including an adequate call system. In making such rules, the
693	agency shall be guided by criteria recommended by nationally
694	recognized reputable professional groups and associations with
695	knowledge of such subject matters. The agency shall update or
696	revise such criteria as the need arises. The agency may require
697	alterations to a building if it determines that an existing
698	condition constitutes a distinct hazard to life, health, or
699	safety. In performing any inspections of facilities authorized
700	by this part or part II of chapter 408, the agency may enforce
701	the special-occupancy provisions of the Florida Building Code
702	and the Florida Fire Prevention Code which apply to nursing
703	homes. Residents or their representatives shall be able to
704	request a change in the placement of the bed in their room,
705	provided that at admission they are presented with a room that
706	meets requirements of the Florida Building Code. The location of
707	a bed may be changed if the requested placement does not
708	infringe on the resident's roommate or interfere with the
709	resident's care or safety as determined by the care planning
710	team in accordance with facility policies and procedures. In
711	addition, the bed placement may not be used as a restraint. Each
712	facility shall maintain a log of resident rooms with beds that
713	are not in strict compliance with the Florida Building Code in
714	order for such log to be used by surveyors and nurse monitors
715	during inspections and visits. A resident or resident
716	representative who requests that a bed be moved shall sign a
717	statement indicating that he or she understands the room will
718	not be in compliance with the Florida Building Code, but they
719	would prefer to exercise their right to self-determination. The
720	statement must be retained as part of the resident's care plan.
721	Any facility that offers this option must submit a letter signed
722	by the nursing home administrator of record to the agency
723	notifying it of this practice with a copy of the policies and
724	procedures of the facility. The agency is directed to provide
725	assistance to the Florida Building Commission in updating the
726	construction standards of the code relative to nursing homes.
727	(b)  The number and qualifications of all personnel,
728	including management, medical, nursing, and other professional
729	personnel, and nursing assistants, orderlies, and support
730	personnel, having responsibility for any part of the care given
731	residents.
732	(c)  All sanitary conditions within the facility and its
733	surroundings, including water supply, sewage disposal, food
734	handling, and general hygiene which will ensure the health and
735	comfort of residents.
736	(d)  The equipment essential to the health and welfare of
737	the residents.
738	(e)  A uniform accounting system.
739	(f)  The care, treatment, and maintenance of residents and
740	measurement of the quality and adequacy thereof, based on rules
741	developed under this chapter and the Omnibus Budget
742	Reconciliation Act of 1987 (Pub. L. No. 100-203) (December 22,
743	1987), Title IV (Medicare, Medicaid, and Other Health-Related
744	Programs), Subtitle C (Nursing Home Reform), as amended.
745	(g)  The preparation and annual update of a comprehensive
746	emergency management plan. The agency shall adopt rules
747	establishing minimum criteria for the plan after consultation
748	with the Department of Community Affairs. At a minimum, the
749	rules must provide for plan components that address emergency
750	evacuation transportation; adequate sheltering arrangements;
751	postdisaster activities, including emergency power, food, and
752	water; postdisaster transportation; supplies; staffing;
753	emergency equipment; individual identification of residents and
754	transfer of records; and responding to family inquiries. The
755	comprehensive emergency management plan is subject to review and
756	approval by the local emergency management agency. During its
757	review, the local emergency management agency shall ensure that
758	the following agencies, at a minimum, are given the opportunity
759	to review the plan: the Department of Elderly Affairs, the
760	Department of Health, the Agency for Health Care Administration,
761	and the Department of Community Affairs. Also, appropriate
762	volunteer organizations must be given the opportunity to review
763	the plan. The local emergency management agency shall complete
764	its review within 60 days and either approve the plan or advise
765	the facility of necessary revisions.
766	(h)  The availability, distribution, and posting of reports
767	and records pursuant to s. 400.191 and the Gold Seal Program
768	pursuant to s. 400.235.
769	(7)  The agency shall, at least every 15 months, evaluate
770	all nursing home facilities and make a determination as to the
771	degree of compliance by each licensee with the established rules
772	adopted under this part as a basis for assigning a licensure
773	status to that facility. The agency shall base its evaluation on
774	the most recent inspection report, taking into consideration
775	findings from other official reports, surveys, interviews,
776	investigations, and inspections. In addition to license
777	categories authorized under part II of chapter 408, the agency
778	shall assign a licensure status of standard or conditional to
779	each nursing home.
780	(a)  A standard licensure status means that a facility does
781	not have any has no class I or class II deficiencies of
782	immediate jeopardy or actual harm that is not immediate jeopardy
783	and has corrected all class III deficiencies with actual harm
784	with the potential for more than minimal harm that is not
785	immediate jeopardy within the time established by the agency.
786	(b)  A conditional licensure status means that a facility
787	does not meet the criteria specified in paragraph (a), due to
788	the presence of one or more class I or class II deficiencies, or
789	class III deficiencies not corrected within the time established
790	by the agency, is not in substantial compliance at the time of
791	the survey with criteria established under this part or with
792	rules adopted by the agency. If the facility has no class I,
793	class II, or class III deficiencies at the time of the followup
794	survey, a standard licensure status may be assigned.
795	(c)  In evaluating the overall quality of care and services
796	and determining whether the facility will receive a conditional
797	or standard license, the agency shall consider the needs and
798	limitations of residents in the facility and the results of
799	interviews and surveys of a representative sampling of
800	residents, families of residents, ombudsman council members in
801	the planning and service area in which the facility is located,
802	guardians of residents, and staff of the nursing home facility.
803	(d)  The current licensure status of each facility must be
804	indicated in bold print on the face of the license. A list of
805	the deficiencies of the facility shall be posted in a prominent
806	place that is in clear and unobstructed public view at or near
807	the place where residents are being admitted to that facility.
808	Licensees receiving a conditional licensure status for a
809	facility shall prepare, within 10 working days after receiving
810	notice of deficiencies, a plan for correction of all
811	deficiencies and shall submit the plan to the agency for
812	approval.
813	(e)  The agency shall adopt rules that:
814	1.  Establish uniform procedures for the evaluation of
815	facilities.
816	2.  Provide criteria in the areas referenced in paragraph
817	(c).
818	3.  Address other areas necessary for carrying out the
819	intent of this section.
820	(8)  The agency shall adopt rules pursuant to this part and
821	part II of chapter 408 to provide that, when the criteria
822	established under subsection (2) are not met, such deficiencies
823	shall be classified according to the nature and the scope of the
824	deficiency. The scope shall be cited as isolated, patterned, or
825	widespread. An isolated deficiency is a deficiency affecting one
826	or a very limited number of residents, or involving one or a
827	very limited number of staff, or a situation that occurred only
828	occasionally or in a very limited number of locations. A
829	patterned deficiency is a deficiency where more than a very
830	limited number of residents are affected, or more than a very
831	limited number of staff are involved, or the situation has
832	occurred in several locations, or the same resident or residents
833	have been affected by repeated occurrences of the same deficient
834	practice but the effect of the deficient practice is not found
835	to be pervasive throughout the facility. A widespread deficiency
836	is a deficiency in which the problems causing the deficiency are
837	pervasive in the facility or represent systemic failure that has
838	affected or has the potential to affect a large portion of the
839	facility's residents. The agency shall indicate the level of
840	seriousness of the deficiency classification on the face of the
841	notice of deficiencies in accordance with 42 U.S.C. chapter 7.
842	as follows:
843	(a)  An immediate jeopardy A class I deficiency is a
844	deficiency that the agency determines presents a situation in
845	which immediate corrective action is necessary because the
846	facility's noncompliance with one or more requirements of
847	participation has caused, or is likely to cause, serious injury,
848	harm, impairment, or death to a resident receiving care in a
849	facility. The condition or practice constituting the a class I
850	violation shall be abated or eliminated immediately, unless a
851	fixed period of time, as determined by the agency, is required
852	for correction. An immediate jeopardy A class I deficiency is
853	subject to a civil penalty of $10,000 for an isolated
854	deficiency, $12,500 for a patterned deficiency, and $15,000 for
855	a widespread deficiency. The fine amount shall be doubled for
856	each deficiency if the facility was previously cited for one or
857	more immediate jeopardy or actual harm that is not immediate
858	jeopardy class I or class II deficiencies during the last
859	licensure inspection or any inspection or complaint
860	investigation since the last licensure inspection. A fine must
861	be levied notwithstanding the correction of the deficiency.
862	(b)  An actual harm that is not immediate jeopardy A class
863	II deficiency is a deficiency that the agency determines has
864	caused actual harm to a resident or residents but does not rise
865	to the level of immediate jeopardy compromised the resident's
866	ability to maintain or reach his or her highest practicable
867	physical, mental, and psychosocial well-being, as defined by an
868	accurate and comprehensive resident assessment, plan of care,
869	and provision of services. Such A class II deficiency is subject
870	to a civil penalty of $2,500 for an isolated deficiency, $5,000
871	for a patterned deficiency, and $7,500 for a widespread
872	deficiency. The fine amount shall be doubled for each deficiency
873	if the facility was previously cited for one or more immediate
874	jeopardy or actual harm that is not immediate jeopardy class I
875	or class II deficiencies during the last licensure inspection or
876	any inspection or complaint investigation since the last
877	licensure inspection. A fine shall be levied notwithstanding the
878	correction of the deficiency.
879	(c)  A class III deficiency that results in no actual harm
880	with the potential for more than minimal harm that is not
881	immediate jeopardy is a deficiency that the agency determines
882	will result in no actual harm to a resident or residents but
883	does have the potential for more than minimal harm but does not
884	rise to the level of immediate jeopardy physical, mental, or
885	psychosocial discomfort to the resident or has the potential to
886	compromise the resident's ability to maintain or reach his or
887	her highest practical physical, mental, or psychosocial well-
888	being, as defined by an accurate and comprehensive resident
889	assessment, plan of care, and provision of services. Such A
890	class III deficiency is subject to a civil penalty of $1,000 for
891	an isolated deficiency, $2,000 for a patterned deficiency, and
892	$3,000 for a widespread deficiency. The fine amount shall be
893	doubled for each deficiency if the facility was previously cited
894	for one or more immediate jeopardy or actual harm that is not
895	immediate jeopardy class I or class II deficiencies during the
896	last licensure inspection or any inspection or complaint
897	investigation since the last licensure inspection. A citation
898	for this level of a class III deficiency must specify the time
899	within which the deficiency is required to be corrected. If the
900	a class III deficiency is corrected within the time specified, a
901	civil penalty may not be imposed.
902	(d)  A class IV deficiency with no actual harm but with the
903	potential for minimal harm is a deficiency that the agency
904	determines has the potential for causing no more than a minor
905	negative impact on the resident. If the class IV deficiency is
906	isolated, no plan of correction is required.
907	Section 19.  Section 400.235, Florida Statutes, is
908	repealed.
909	Section 20.  Subsection (1) of section 408.035, Florida
910	Statutes, is amended to read:
911	408.035  Review criteria.--
912	(1)  The agency shall determine the reviewability of
913	applications and shall review applications for certificate-of-
914	need determinations for health care facilities and health
915	services in context with the following criteria, except for
916	general hospitals as defined in s. 395.002:
917	(a)  The need for the health care facilities and health
918	services being proposed.
919	(b)  The availability, quality of care, accessibility, and
920	extent of utilization of existing health care facilities and
921	health services in the service district of the applicant.
922	(c)  The ability of the applicant to provide quality of
923	care and the applicant's record of providing quality of care.
924	(d)  The availability of resources, including health
925	personnel, management personnel, and funds for capital and
926	operating expenditures, for project accomplishment and
927	operation.
928	(e)  The extent to which the proposed services will enhance
929	access to health care for residents of the service district.
930	(f)  The immediate and long-term financial feasibility of
931	the proposal.
932	(g)  The extent to which the proposal will foster
933	competition that promotes quality and cost-effectiveness.
934	(h)  The costs and methods of the proposed construction,
935	including the costs and methods of energy provision and the
936	availability of alternative, less costly, or more effective
937	methods of construction.
938	(i)  The applicant's past and proposed provision of health
939	care services to Medicaid patients and the medically indigent.
940	(j)  The applicant's designation as a Gold Seal Program
941	nursing facility pursuant to s. 400.235, when the applicant is
942	requesting additional nursing home beds at that facility.
943	Section 21.  Paragraph (k) of subsection (3) of section
944	408.036, Florida Statutes, is repealed.
945	Section 22.  Paragraph (d) of subsection (15) of section
946	409.912, Florida Statutes, is repealed.
947	Section 23.  Subsection (3) is added to section 465.017,
948	Florida Statutes, to read:
949	465.017  Authority to inspect; disposal.--
950	(3)  Nursing homes that are licensed under part II of
951	chapter 400 and inspected by the Agency for Health Care
952	Administration as part of state licensing requirements and
953	federal certification requirements are exempt from inspection by
954	the department.
955	Section 24.  Section 633.081, Florida Statutes, is amended
956	to read:
957	633.081  Inspection of buildings and equipment; orders;
958	firesafety inspection training requirements; certification;
959	disciplinary action.--The State Fire Marshal and her or his
960	agents shall, at any reasonable hour, when the department has
961	reasonable cause to believe that a violation of this chapter or
962	s. 509.215, or a rule promulgated thereunder, or a minimum
963	firesafety code adopted by a local authority, may exist, inspect
964	any and all buildings and structures which are subject to the
965	requirements of this chapter or s. 509.215 and rules promulgated
966	thereunder. The authority to inspect shall extend to all
967	equipment, vehicles, and chemicals which are located within the
968	premises of any such building or structure. Nursing homes that
969	are licensed under part II of chapter 400 and inspected by the
970	Agency for Health Care Administration as part of state licensing
971	requirements and federal certification requirements are exempt
972	from inspection by the State Fire Marshal and her or his agents
973	if the agency's inspection satisfies inspection requirements of
974	the State Fire Marshal.
975	(1)  Each county, municipality, and special district that
976	has firesafety enforcement responsibilities shall employ or
977	contract with a firesafety inspector. The firesafety inspector
978	must conduct all firesafety inspections that are required by
979	law. The governing body of a county, municipality, or special
980	district that has firesafety enforcement responsibilities may
981	provide a schedule of fees to pay only the costs of inspections
982	conducted pursuant to this subsection and related administrative
983	expenses. Two or more counties, municipalities, or special
984	districts that have firesafety enforcement responsibilities may
985	jointly employ or contract with a firesafety inspector.
986	(2)  Every firesafety inspection conducted pursuant to
987	state or local firesafety requirements shall be by a person
988	certified as having met the inspection training requirements set
989	by the State Fire Marshal. Such person shall:
990	(a)  Be a high school graduate or the equivalent as
991	determined by the department;
992	(b)  Not have been found guilty of, or having pleaded
993	guilty or nolo contendere to, a felony or a crime punishable by
994	imprisonment of 1 year or more under the law of the United
995	States, or of any state thereof, which involves moral turpitude,
996	without regard to whether a judgment of conviction has been
997	entered by the court having jurisdiction of such cases;
998	(c)  Have her or his fingerprints on file with the
999	department or with an agency designated by the department;
1000	(d)  Have good moral character as determined by the
1001	department;
1002	(e)  Be at least 18 years of age;
1003	(f)  Have satisfactorily completed the firesafety inspector
1004	certification examination as prescribed by the department; and
1005	(g)1.  Have satisfactorily completed, as determined by the
1006	department, a firesafety inspector training program of not less
1007	than 200 hours established by the department and administered by
1008	agencies and institutions approved by the department for the
1009	purpose of providing basic certification training for firesafety
1010	inspectors; or
1011	2.  Have received in another state training which is
1012	determined by the department to be at least equivalent to that
1013	required by the department for approved firesafety inspector
1014	education and training programs in this state.
1015	(3)  Each special state firesafety inspection which is
1016	required by law and is conducted by or on behalf of an agency of
1017	the state must be performed by an individual who has met the
1018	provision of subsection (2), except that the duration of the
1019	training program shall not exceed 120 hours of specific training
1020	for the type of property that such special state firesafety
1021	inspectors are assigned to inspect.
1022	(4)  A firefighter certified pursuant to s. 633.35 may
1023	conduct firesafety inspections, under the supervision of a
1024	certified firesafety inspector, while on duty as a member of a
1025	fire department company conducting inservice firesafety
1026	inspections without being certified as a firesafety inspector,
1027	if such firefighter has satisfactorily completed an inservice
1028	fire department company inspector training program of at least
1029	24 hours' duration as provided by rule of the department.
1030	(5)  Every firesafety inspector or special state firesafety
1031	inspector certificate is valid for a period of 3 years from the
1032	date of issuance. Renewal of certification shall be subject to
1033	the affected person's completing proper application for renewal
1034	and meeting all of the requirements for renewal as established
1035	under this chapter or by rule promulgated thereunder, which
1036	shall include completion of at least 40 hours during the
1037	preceding 3-year period of continuing education as required by
1038	the rule of the department or, in lieu thereof, successful
1039	passage of an examination as established by the department.
1040	(6)  The State Fire Marshal may deny, refuse to renew,
1041	suspend, or revoke the certificate of a firesafety inspector or
1042	special state firesafety inspector if it finds that any of the
1043	following grounds exist:
1044	(a)  Any cause for which issuance of a certificate could
1045	have been refused had it then existed and been known to the
1046	State Fire Marshal.
1047	(b)  Violation of this chapter or any rule or order of the
1048	State Fire Marshal.
1049	(c)  Falsification of records relating to the certificate.
1050	(d)  Having been found guilty of or having pleaded guilty
1051	or nolo contendere to a felony, whether or not a judgment of
1052	conviction has been entered.
1053	(e)  Failure to meet any of the renewal requirements.
1054	(f)  Having been convicted of a crime in any jurisdiction
1055	which directly relates to the practice of fire code inspection,
1056	plan review, or administration.
1057	(g)  Making or filing a report or record that the
1058	certificateholder knows to be false, or knowingly inducing
1059	another to file a false report or record, or knowingly failing
1060	to file a report or record required by state or local law, or
1061	knowingly impeding or obstructing such filing, or knowingly
1062	inducing another person to impede or obstruct such filing.
1063	(h)  Failing to properly enforce applicable fire codes or
1064	permit requirements within this state which the
1065	certificateholder knows are applicable by committing willful
1066	misconduct, gross negligence, gross misconduct, repeated
1067	negligence, or negligence resulting in a significant danger to
1068	life or property.
1069	(i)  Accepting labor, services, or materials at no charge
1070	or at a noncompetitive rate from any person who performs work
1071	that is under the enforcement authority of the certificateholder
1072	and who is not an immediate family member of the
1073	certificateholder. For the purpose of this paragraph, the term
1074	"immediate family member" means a spouse, child, parent,
1075	sibling, grandparent, aunt, uncle, or first cousin of the person
1076	or the person's spouse or any person who resides in the primary
1077	residence of the certificateholder.
1078	(7)  The department shall provide by rule for the
1079	certification of firesafety inspectors.
1080	Section 25.  This act shall take effect July 1, 2009.

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