Florida Senate - 2009                        COMMITTEE AMENDMENT
       Bill No. SB 1562
       
       
       
       
       
       
                                Barcode 600066                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/25/2009           .                                
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       The Committee on Health Regulation (Bennett) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (a) of subsection (2) of section
    6  381.0072, Florida Statutes, is amended to read:
    7         381.0072 Food service protection.—It shall be the duty of
    8  the Department of Health to adopt and enforce sanitation rules
    9  consistent with law to ensure the protection of the public from
   10  food-borne illness. These rules shall provide the standards and
   11  requirements for the storage, preparation, serving, or display
   12  of food in food service establishments as defined in this
   13  section and which are not permitted or licensed under chapter
   14  500 or chapter 509.
   15         (2) DUTIES.—
   16         (a) The department shall adopt rules, including definitions
   17  of terms which are consistent with law prescribing minimum
   18  sanitation standards and manager certification requirements as
   19  prescribed in s. 509.039, and which shall be enforced in food
   20  service establishments as defined in this section. The
   21  sanitation standards must address the construction, operation,
   22  and maintenance of the establishment; lighting, ventilation,
   23  laundry rooms, lockers, use and storage of toxic materials and
   24  cleaning compounds, and first-aid supplies; plan review; design,
   25  construction, installation, location, maintenance, sanitation,
   26  and storage of food equipment and utensils; employee training,
   27  health, hygiene, and work practices; food supplies, preparation,
   28  storage, transportation, and service, including access to the
   29  areas where food is stored or prepared; and sanitary facilities
   30  and controls, including water supply and sewage disposal;
   31  plumbing and toilet facilities; garbage and refuse collection,
   32  storage, and disposal; and vermin control. Public and private
   33  schools, if the food service is operated by school employees;
   34  hospitals licensed under chapter 395; nursing homes licensed
   35  under part II of chapter 400; child care facilities as defined
   36  in s. 402.301; residential facilities colocated with a nursing
   37  home or hospital, if all food is prepared in a central kitchen
   38  that complies with nursing or hospital regulations; and bars and
   39  lounges, as defined by department rule, are exempt from the
   40  rules developed for manager certification. The department shall
   41  administer a comprehensive inspection, monitoring, and sampling
   42  program to ensure such standards are maintained; however,
   43  nursing homes that are licensed under part II of chapter 400 and
   44  inspected by the Agency for Health Care Administration as part
   45  of the state licensing requirements or federal certification
   46  requirements are exempt from routine inspection by the
   47  department, as required under this part, and are exempt from the
   48  fee imposed pursuant to this section. With respect to food
   49  service establishments permitted or licensed under chapter 500
   50  or chapter 509, the department shall assist the Division of
   51  Hotels and Restaurants of the Department of Business and
   52  Professional Regulation and the Department of Agriculture and
   53  Consumer Services with rulemaking by providing technical
   54  information.
   55         Section 2. Paragraph (b) of subsection (6) of section
   56  381.0098, Florida Statutes, is amended to read:
   57         381.0098 Biomedical waste.—
   58         (6) TRACKING SYSTEM.—The department shall adopt rules for a
   59  system of tracking biomedical waste.
   60         (b) Inspections may be conducted for purposes of compliance
   61  with this section. Any such inspection shall be commenced and
   62  completed with reasonable promptness. However, nursing homes
   63  that are licensed under part II of chapter 400 and inspected by
   64  the Agency for Health Care Administration as part of the state
   65  licensing requirements or federal certification requirements are
   66  exempt from routine inspection by the department, as required
   67  under this part, and are exempt from the fee imposed pursuant to
   68  this section. If the officer, employee, or representative of the
   69  department obtains any samples, prior to leaving the premises he
   70  or she shall give the owner, operator, or agent in charge a
   71  receipt describing the sample obtained.
   72         Section 3. Subsection (1) of section 400.0060, Florida
   73  Statutes, is repealed.
   74         Section 4. Subsection (2) of section 400.0061, Florida
   75  Statutes, is amended to read:
   76         400.0061 Legislative findings and intent; long-term care
   77  facilities.—
   78         (2) It is the intent of the Legislature, therefore, to
   79  utilize voluntary citizen ombudsman councils under the
   80  leadership of the ombudsman, and through them to operate an
   81  ombudsman program which shall, without interference by any
   82  executive agency, undertake to discover, investigate, and
   83  determine the presence of conditions or individuals which
   84  constitute a threat to the rights, health, safety, or welfare of
   85  the residents of long-term care facilities. To ensure that the
   86  effectiveness and efficiency of such investigations are not
   87  impeded by advance notice or delay, the Legislature intends that
   88  the ombudsman and ombudsman councils and their designated
   89  representatives not be required to obtain warrants in order to
   90  enter into or conduct investigations or onsite administrative
   91  assessments of long-term care facilities. It is the further
   92  intent of the Legislature that the environment in long-term care
   93  facilities be conducive to the dignity and independence of
   94  residents and that investigations by ombudsman councils shall
   95  further the enforcement of laws, rules, and regulations that
   96  safeguard the health, safety, and welfare of residents. This
   97  section does not preclude an ombudsman from entering a facility
   98  pursuant to the Older Americans Act of 1965, as amended, in
   99  order to provide services to protect the health, safety, welfare
  100  and rights of residents while ensuring that residents have
  101  regular and timely access to representatives of the ombudsman
  102  program.
  103         Section 5. Paragraph (a) of subsection (1) of section
  104  400.0065, Florida Statutes, is amended to read:
  105         400.0065 State Long-Term Care Ombudsman; duties and
  106  responsibilities.—
  107         (1) The purpose of the Office of State Long-Term Care
  108  Ombudsman shall be to:
  109         (a) Identify, investigate, and resolve complaints made by
  110  or on behalf of residents of long-term care facilities,
  111  regardless of the person who makes the complaint, including an
  112  employee of the long-term care facility, relating to actions or
  113  omissions by providers or representatives of providers of long
  114  term care services, other public or private agencies, guardians,
  115  or representative payees which that may adversely affect the
  116  health, safety, welfare, or rights of the residents.
  117         Section 6. Paragraphs (b) and (d) of subsection (2) of
  118  section 400.0067, Florida Statutes, are amended to read:
  119         400.0067 State Long-Term Care Ombudsman Council; duties;
  120  membership.—
  121         (2) The State Long-Term Care Ombudsman Council shall:
  122         (b) Serve as an appellate body in receiving from the local
  123  councils complaints not resolved at the local level. Any
  124  individual member or members of the state council may enter any
  125  long-term care facility involved in an appeal, pursuant to the
  126  conditions specified in s. 400.0074(2).
  127         (d) Assist the ombudsman in eliciting, receiving,
  128  responding to, and resolving complaints made by or on behalf of
  129  residents regardless of the person who makes the complaint,
  130  including an employee of a long-term care facility.
  131         Section 7. Paragraph (c) of subsection (2) and subsection
  132  (3) of section 400.0069, Florida Statutes, are amended to read:
  133         400.0069 Local long-term care ombudsman councils; duties;
  134  membership.—
  135         (2) The duties of the local councils are to:
  136         (c) Elicit, receive, investigate, respond to, and resolve
  137  complaints made by or on behalf of residents regardless of the
  138  person who makes the complaint, including an employee of a long
  139  term care facility.
  140         (3) In order to carry out the duties specified in
  141  subsection (2), a member of a local council is authorized to
  142  enter any long-term care facility without notice or first
  143  obtaining a warrant, subject to the provisions of s.
  144  400.0074(2).
  145         Section 8. Section 400.0071, Florida Statutes, is amended
  146  to read:
  147         400.0071 State Long-Term Care Ombudsman Program complaint
  148  procedures.—The department shall adopt rules implementing state
  149  and local complaint procedures. The rules must include
  150  procedures for:
  151         (1) Receiving complaints against a long-term care facility
  152  or an employee of a long-term care facility regardless of the
  153  person who makes the complaint.
  154         (2) Conducting investigations of a long-term care facility
  155  or an employee of a long-term care facility subsequent to
  156  receiving a complaint.
  157         (3) Conducting onsite administrative assessments of long
  158  term care facilities.
  159         Section 9. Section 400.0074, Florida Statutes, is repealed.
  160         Section 10. Paragraph (a) of subsection (1) of section
  161  400.0075, Florida Statutes, is amended to read:
  162         400.0075 Complaint notification and resolution procedures.—
  163         (1)(a) Any complaint or problem verified by an ombudsman
  164  council as a result of an investigation or onsite administrative
  165  assessment, which complaint or problem is determined to require
  166  remedial action by the local council, shall be identified and
  167  brought to the attention of the long-term care facility
  168  administrator in writing. Upon receipt of such document, the
  169  administrator, with the concurrence of the local council chair,
  170  shall establish target dates for taking appropriate remedial
  171  action. If, by the target date, the remedial action is not
  172  completed or forthcoming, the local council chair may, after
  173  obtaining approval from the ombudsman and a majority of the
  174  members of the local council:
  175         1. Extend the target date if the chair has reason to
  176  believe such action would facilitate the resolution of the
  177  complaint.
  178         2. In accordance with s. 400.0077, publicize the complaint,
  179  the recommendations of the council, and the response of the
  180  long-term care facility.
  181         3. Refer the complaint to the state council.
  182         Section 11. Subsection (3) of section 400.19, Florida
  183  Statutes, is amended to read:
  184         400.19 Right of entry and inspection.—
  185         (3) The agency shall every 15 months conduct at least one
  186  unannounced inspection to determine compliance by the licensee
  187  with statutes, with federal requirements, if applicable, and
  188  with rules adopted promulgated under the provisions of those
  189  statutes and federal requirements, governing minimum standards
  190  of construction, quality and adequacy of care, and rights of
  191  residents. The survey shall be conducted every 6 months for the
  192  next 2-year period if the facility has been cited for a class I
  193  deficiency, has been cited for two or more class II deficiencies
  194  arising from separate surveys or investigations within a 60-day
  195  period, or has had three or more substantiated complaints within
  196  a 6-month period, each resulting in at least one class I or
  197  class II deficiency. In addition to any other fees or fines in
  198  this part, the agency shall assess a fine for each facility that
  199  is subject to the 6-month survey cycle. The fine for the 2-year
  200  period shall be $6,000, one-half to be paid at the completion of
  201  each survey. The agency may adjust this fine by the change in
  202  the Consumer Price Index, based on the 12 months immediately
  203  preceding the increase, to cover the cost of the additional
  204  surveys. The agency shall verify through subsequent inspection
  205  that any deficiency identified during inspection is corrected.
  206  However, the agency may verify the correction of a class III or
  207  class IV deficiency unrelated to resident rights or resident
  208  care without reinspecting the facility if adequate written
  209  documentation has been received from the facility, which
  210  provides assurance that the deficiency has been corrected. The
  211  giving or causing to be given of advance notice of such
  212  unannounced inspections by an employee of the agency to any
  213  unauthorized person shall constitute cause for suspension of not
  214  fewer than 5 working days according to the provisions of chapter
  215  110.
  216         Section 12. Section 400.191, Florida Statutes, is amended
  217  to read:
  218         400.191 Availability, distribution, and posting of reports
  219  and records.—
  220         (1) The agency shall provide information to the public
  221  about all of the licensed nursing home facilities operating in
  222  the state. The agency shall, within 60 days after a licensure
  223  inspection visit or within 30 days after any interim visit to a
  224  facility, send copies of the inspection reports to the local
  225  long-term care ombudsman council, the agency’s local office, and
  226  a public library or the county seat for the county in which the
  227  facility is located. The agency may provide electronic access to
  228  inspection reports as a substitute for sending copies.
  229         (2)The agency shall publish the Nursing Home Guide
  230  annually in consumer-friendly printed form and quarterly in
  231  electronic form to assist consumers and their families in
  232  comparing and evaluating nursing home facilities.
  233         (a)The agency shall provide an Internet site which shall
  234  include at least the following information either directly or
  235  indirectly through a link to another established site or sites
  236  of the agency’s choosing:
  237         1.A section entitled “Have you considered programs that
  238  provide alternatives to nursing home care?” which shall be the
  239  first section of the Nursing Home Guide and which shall
  240  prominently display information about available alternatives to
  241  nursing homes and how to obtain additional information regarding
  242  these alternatives. The Nursing Home Guide shall explain that
  243  this state offers alternative programs that permit qualified
  244  elderly persons to stay in their homes instead of being placed
  245  in nursing homes and shall encourage interested persons to call
  246  the Comprehensive Assessment Review and Evaluation for Long-Term
  247  Care Services (CARES) Program to inquire if they qualify. The
  248  Nursing Home Guide shall list available home and community-based
  249  programs which shall clearly state the services that are
  250  provided and indicate whether nursing home services are included
  251  if needed. 2. A list by name and address of all nursing home
  252  facilities in this state, including any prior name by which a
  253  facility was known during the previous 24-month period.
  254         3.Whether such nursing home facilities are proprietary or
  255  nonproprietary.
  256         4.The current owner of the facility’s license and the year
  257  that that entity became the owner of the license.
  258         5.The name of the owner or owners of each facility and
  259  whether the facility is affiliated with a company or other
  260  organization owning or managing more than one nursing facility
  261  in this state.
  262         6.The total number of beds in each facility and the most
  263  recently available occupancy levels.
  264         7.The number of private and semiprivate rooms in each
  265  facility.
  266         8.The religious affiliation, if any, of each facility.
  267         9.The languages spoken by the administrator and staff of
  268  each facility.
  269         10.Whether or not each facility accepts Medicare or
  270  Medicaid recipients or insurance, health maintenance
  271  organization, Veterans Administration, CHAMPUS program, or
  272  workers’ compensation coverage.
  273         11.Recreational and other programs available at each
  274  facility.
  275         12.Special care units or programs offered at each
  276  facility.
  277         13.Whether the facility is a part of a retirement
  278  community that offers other services pursuant to part III of
  279  this chapter or part I or part III of chapter 429.
  280         14.Survey and deficiency information, including all
  281  federal and state recertification, licensure, revisit, and
  282  complaint survey information, for each facility for the past 30
  283  months. For noncertified nursing homes, state survey and
  284  deficiency information, including licensure, revisit, and
  285  complaint survey information for the past 30 months shall be
  286  provided.
  287         15.A summary of the deficiency data for each facility over
  288  the past 30 months. The summary may include a score, rating, or
  289  comparison ranking with respect to other facilities based on the
  290  number of citations received by the facility on recertification,
  291  licensure, revisit, and complaint surveys; the severity and
  292  scope of the citations; and the number of recertification
  293  surveys the facility has had during the past 30 months. The
  294  score, rating, or comparison ranking may be presented in either
  295  numeric or symbolic form for the intended consumer audience.
  296         (b)The agency shall provide the following information in
  297  printed form:
  298         1.A section entitled “Have you considered programs that
  299  provide alternatives to nursing home care?” which shall be the
  300  first section of the Nursing Home Guide and which shall
  301  prominently display information about available alternatives to
  302  nursing homes and how to obtain additional information regarding
  303  these alternatives. The Nursing Home Guide shall explain that
  304  this state offers alternative programs that permit qualified
  305  elderly persons to stay in their homes instead of being placed
  306  in nursing homes and shall encourage interested persons to call
  307  the Comprehensive Assessment Review and Evaluation for Long-Term
  308  Care Services (CARES) Program to inquire if they qualify. The
  309  Nursing Home Guide shall list available home and community-based
  310  programs which shall clearly state the services that are
  311  provided and indicate whether nursing home services are included
  312  if needed.
  313         2.A list by name and address of all nursing home
  314  facilities in this state.
  315         3.Whether the nursing home facilities are proprietary or
  316  nonproprietary.
  317         4.The current owner or owners of the facility’s license
  318  and the year that entity became the owner of the license.
  319         5.The total number of beds, and of private and semiprivate
  320  rooms, in each facility.
  321         6.The religious affiliation, if any, of each facility.
  322         7.The name of the owner of each facility and whether the
  323  facility is affiliated with a company or other organization
  324  owning or managing more than one nursing facility in this state.
  325         8.The languages spoken by the administrator and staff of
  326  each facility.
  327         9.Whether or not each facility accepts Medicare or
  328  Medicaid recipients or insurance, health maintenance
  329  organization, Veterans Administration, CHAMPUS program, or
  330  workers’ compensation coverage.
  331         10.Recreational programs, special care units, and other
  332  programs available at each facility.
  333         11.The Internet address for the site where more detailed
  334  information can be seen.
  335         12.A statement advising consumers that each facility will
  336  have its own policies and procedures related to protecting
  337  resident property.
  338         13.A summary of the deficiency data for each facility over
  339  the past 30 months. The summary may include a score, rating, or
  340  comparison ranking with respect to other facilities based on the
  341  number of citations received by the facility on recertification,
  342  licensure, revisit, and complaint surveys; the severity and
  343  scope of the citations; the number of citations; and the number
  344  of recertification surveys the facility has had during the past
  345  30 months. The score, rating, or comparison ranking may be
  346  presented in either numeric or symbolic form for the intended
  347  consumer audience.
  348         (c)The agency may provide the following additional
  349  information on an Internet site or in printed form as the
  350  information becomes available:
  351         1.The licensure status history of each facility.
  352         2.The rating history of each facility.
  353         3.The regulatory history of each facility, which may
  354  include federal sanctions, state sanctions, federal fines, state
  355  fines, and other actions.
  356         4.Whether the facility currently possesses the Gold Seal
  357  designation awarded pursuant to s. 400.235.
  358         5.Internet links to the Internet sites of the facilities
  359  or their affiliates.
  360         (2)(3) Each nursing home facility licensee shall maintain
  361  as public information, available upon request, records of all
  362  cost and inspection reports pertaining to that facility that
  363  have been filed with, or issued by, any governmental agency.
  364  Copies of the reports shall be retained in the records for not
  365  less than 5 years following the date the reports are filed or
  366  issued.
  367         (a)The agency shall publish in the Nursing Home Guide a
  368  “Nursing Home Guide Watch List” to assist consumers in
  369  evaluating the quality of nursing home care in Florida. The
  370  watch list must identify each facility that met the criteria for
  371  a conditional licensure status and each facility that is
  372  operating under bankruptcy protection. The watch list must
  373  include, but is not limited to, the facility’s name, address,
  374  and ownership; the county in which the facility operates; the
  375  license expiration date; the number of licensed beds; a
  376  description of the deficiency causing the facility to be placed
  377  on the list; any corrective action taken; and the cumulative
  378  number of days and percentage of days the facility had a
  379  conditional license in the past 30 months. The watch list must
  380  include a brief description regarding how to choose a nursing
  381  home, the categories of licensure, the agency’s inspection
  382  process, an explanation of terms used in the watch list, and the
  383  addresses and phone numbers of the agency’s health quality
  384  assurance field offices.
  385         (b)Upon publication of each Nursing Home Guide, the agency
  386  must post a copy on its website by the 15th calendar day of the
  387  second month following the end of the calendar quarter. Each
  388  nursing home licensee must retrieve the most recent version of
  389  the Nursing Home Guide from the agency’s website.
  390         (3)(4) Any records of a nursing home facility determined by
  391  the agency to be necessary and essential to establish lawful
  392  compliance with any rules or standards must be made available to
  393  the agency on the premises of the facility and submitted to the
  394  agency. Each facility must submit this information to the agency
  395  by electronic transmission when available.
  396         (4)(5) Every nursing home facility licensee shall:
  397         (a) Post, in a sufficient number of prominent positions in
  398  the nursing home so as to be accessible to all residents and to
  399  the general public,:
  400         1. a concise summary of the last inspection report
  401  pertaining to the nursing home and issued by the agency, with
  402  references to the page numbers of the full reports, noting any
  403  deficiencies found by the agency and the actions taken by the
  404  licensee to rectify the deficiencies and indicating in the
  405  summaries where the full reports may be inspected in the nursing
  406  home.
  407         2.A copy of all of the pages that list the facility in the
  408  most recent version of the Nursing Home Guide.
  409         (b) Upon request, provide to any person who has completed a
  410  written application with an intent to be admitted to, or to any
  411  resident of, a nursing home, or to any relative, spouse, or
  412  guardian of the person, a copy of the last inspection report
  413  pertaining to the nursing home and issued by the agency,
  414  provided the person requesting the report agrees to pay a
  415  reasonable charge to cover copying costs.
  416         (c)Have readily available a copy of the facility’s page
  417  from the federal Nursing Home Compare website which includes the
  418  facility’s Five-Star Quality Ratings.
  419         (5)(6) The agency may adopt rules as necessary to
  420  administer this section.
  421         Section 13. Paragraph (d) of subsection (1) of section
  422  400.195, Florida Statutes, is amended to read:
  423         400.195 Agency reporting requirements.—
  424         (1) For the period beginning June 30, 2001, and ending June
  425  30, 2005, the Agency for Health Care Administration shall
  426  provide a report to the Governor, the President of the Senate,
  427  and the Speaker of the House of Representatives with respect to
  428  nursing homes. The first report shall be submitted no later than
  429  December 30, 2002, and subsequent reports shall be submitted
  430  every 6 months thereafter. The report shall identify facilities
  431  based on their ownership characteristics, size, business
  432  structure, for-profit or not-for-profit status, and any other
  433  characteristics the agency determines useful in analyzing the
  434  varied segments of the nursing home industry and shall report:
  435         (d) Information regarding deficiencies cited, including
  436  information used to develop the Nursing Home Guide WATCH LIST
  437  pursuant to s. 400.191, and applicable rules, a summary of data
  438  generated on nursing homes by Centers for Medicare and Medicaid
  439  Services Nursing Home Quality Information Project, and
  440  information collected pursuant to s. 400.147(9), relating to
  441  litigation.
  442         Section 14. Subsection (8) of section 400.23, Florida
  443  Statutes, is amended to read:
  444         400.23 Rules; evaluation and deficiencies; licensure
  445  status.—
  446         (8) The agency shall adopt rules pursuant to this part and
  447  part II of chapter 408 to provide that, when the criteria
  448  established under subsection (2) are not met, such deficiencies
  449  shall be classified according to the nature and the scope of the
  450  deficiency. The scope shall be cited as isolated, patterned, or
  451  widespread. An isolated deficiency is a deficiency affecting one
  452  or a very limited number of residents, or involving one or a
  453  very limited number of staff, or a situation that occurred only
  454  occasionally or in a very limited number of locations. A
  455  patterned deficiency is a deficiency where more than a very
  456  limited number of residents are affected, or more than a very
  457  limited number of staff are involved, or the situation has
  458  occurred in several locations, or the same resident or residents
  459  have been affected by repeated occurrences of the same deficient
  460  practice but the effect of the deficient practice is not found
  461  to be pervasive throughout the facility. A widespread deficiency
  462  is a deficiency in which the problems causing the deficiency are
  463  pervasive in the facility or represent systemic failure that has
  464  affected or has the potential to affect a large portion of the
  465  facility’s residents. The agency shall indicate the
  466  classification on the face of the notice of deficiencies in
  467  accordance with chapter 7, State Operations Manual, published by
  468  the Centers for Medicare and Medicaid Services as follows:
  469         (a) A class I deficiency is a deficiency that the agency
  470  determines presents a situation in which immediate corrective
  471  action is necessary because the facility’s noncompliance with
  472  one or more requirements of participation has caused, or is
  473  likely to cause, immediate jeopardy to the health or safety of
  474  serious injury, harm, impairment, or death to a resident
  475  receiving care in a facility. The condition or practice
  476  constituting a class I violation shall be abated or eliminated
  477  immediately, unless a fixed period of time, as determined by the
  478  agency, is required for correction. A class I deficiency is
  479  subject to a civil penalty of $10,000 for an isolated deficiency
  480  (J), $12,500 for a patterned deficiency (K), and $15,000 for a
  481  widespread deficiency (L). The fine amount shall be doubled for
  482  each deficiency if the facility was previously cited for one or
  483  more class I or class II deficiencies during the last licensure
  484  inspection or any inspection or complaint investigation since
  485  the last licensure inspection. A fine must be levied
  486  notwithstanding the correction of the deficiency.
  487         (b) A class II deficiency is a deficiency that the agency
  488  determines has caused actual harm to a resident or residents but
  489  does not rise to the level of immediate jeopardy compromised the
  490  resident’s ability to maintain or reach his or her highest
  491  practicable physical, mental, and psychosocial well-being, as
  492  defined by an accurate and comprehensive resident assessment,
  493  plan of care, and provision of services. A class II deficiency
  494  is subject to a civil penalty of $2,500 for an isolated
  495  deficiency (G), $5,000 for a patterned deficiency (H), and
  496  $7,500 for a widespread deficiency (I). The fine amount shall be
  497  doubled for each deficiency if the facility was previously cited
  498  for one or more class I or class II deficiencies during the last
  499  licensure inspection or any inspection or complaint
  500  investigation since the last licensure inspection. A fine shall
  501  be levied notwithstanding the correction of the deficiency.
  502         (c) A class III deficiency is a deficiency that the agency
  503  determines will not result in actual harm to a resident or
  504  residents but does have the potential for no more than minimal
  505  harm that does not rise to the level of immediate jeopardy
  506  physical, mental, or psychosocial discomfort to the resident or
  507  has the potential to compromise the resident’s ability to
  508  maintain or reach his or her highest practical physical, mental,
  509  or psychosocial well-being, as defined by an accurate and
  510  comprehensive resident assessment, plan of care, and provision
  511  of services. A class III deficiency is subject to a civil
  512  penalty of $1,000 for an isolated deficiency (D), $2,000 for a
  513  patterned deficiency (E), and $3,000 for a widespread deficiency
  514  (F). The fine amount shall be doubled for each deficiency if the
  515  facility was previously cited for one or more class I or class
  516  II deficiencies during the last licensure inspection or any
  517  inspection or complaint investigation since the last licensure
  518  inspection. A citation for a class III deficiency must specify
  519  the time within which the deficiency is required to be
  520  corrected. If a class III deficiency is corrected within the
  521  time specified, a civil penalty may not be imposed.
  522         (d) A class IV deficiency is a deficiency that does not
  523  result in actual harm but has the potential for minimal harm to
  524  a that the agency determines has the potential for causing no
  525  more than a minor negative impact on the resident (A, B, or C).
  526  If the class IV deficiency is isolated, no plan of correction is
  527  required.
  528         Section 15. Subsection (3) is added to section 465.017,
  529  Florida Statutes, to read:
  530         465.017  Authority to inspect; disposal.—
  531         (3)Nursing homes that are licensed under part II of
  532  chapter 400 and inspected by the Agency for Health Care
  533  Administration pursuant to the state licensing requirements and
  534  federal certification requirements are exempt from routine
  535  inspection by the department, as required under this part, and
  536  are exempt from the fee imposed pursuant to this section.
  537         Section 16. Section 633.081, Florida Statutes, is amended
  538  to read:
  539         633.081 Inspection of buildings and equipment; orders;
  540  firesafety inspection training requirements; certification;
  541  disciplinary action.—The State Fire Marshal and her or his
  542  agents shall, at any reasonable hour, when the department has
  543  reasonable cause to believe that a violation of this chapter or
  544  s. 509.215, or a rule promulgated thereunder, or a minimum
  545  firesafety code adopted by a local authority, may exist, inspect
  546  any and all buildings and structures which are subject to the
  547  requirements of this chapter or s. 509.215 and rules promulgated
  548  thereunder. The authority to inspect shall extend to all
  549  equipment, vehicles, and chemicals which are located within the
  550  premises of any such building or structure. Nursing homes that
  551  are licensed under part II of chapter 400 and inspected by the
  552  Agency for Health Care Administration pursuant to the state
  553  licensing requirements and federal certification requirements
  554  are exempt from inspection by the State Fire Marshal, or his or
  555  her agents, if, in the opinion of the State Fire Marshal or his
  556  representative, the agency’s inspection satisfies the inspection
  557  requirements of the State Fire Marshal.
  558         (1) Each county, municipality, and special district that
  559  has firesafety enforcement responsibilities shall employ or
  560  contract with a firesafety inspector. The firesafety inspector
  561  must conduct all firesafety inspections that are required by
  562  law. The governing body of a county, municipality, or special
  563  district that has firesafety enforcement responsibilities may
  564  provide a schedule of fees to pay only the costs of inspections
  565  conducted pursuant to this subsection and related administrative
  566  expenses. Two or more counties, municipalities, or special
  567  districts that have firesafety enforcement responsibilities may
  568  jointly employ or contract with a firesafety inspector.
  569         (2) Every firesafety inspection conducted pursuant to state
  570  or local firesafety requirements shall be by a person certified
  571  as having met the inspection training requirements set by the
  572  State Fire Marshal. Such person shall:
  573         (a) Be a high school graduate or the equivalent as
  574  determined by the department;
  575         (b) Not have been found guilty of, or having pleaded guilty
  576  or nolo contendere to, a felony or a crime punishable by
  577  imprisonment of 1 year or more under the law of the United
  578  States, or of any state thereof, which involves moral turpitude,
  579  without regard to whether a judgment of conviction has been
  580  entered by the court having jurisdiction of such cases;
  581         (c) Have her or his fingerprints on file with the
  582  department or with an agency designated by the department;
  583         (d) Have good moral character as determined by the
  584  department;
  585         (e) Be at least 18 years of age;
  586         (f) Have satisfactorily completed the firesafety inspector
  587  certification examination as prescribed by the department; and
  588         (g)1. Have satisfactorily completed, as determined by the
  589  department, a firesafety inspector training program of not less
  590  than 200 hours established by the department and administered by
  591  agencies and institutions approved by the department for the
  592  purpose of providing basic certification training for firesafety
  593  inspectors; or
  594         2. Have received in another state training which is
  595  determined by the department to be at least equivalent to that
  596  required by the department for approved firesafety inspector
  597  education and training programs in this state.
  598         (3) Each special state firesafety inspection which is
  599  required by law and is conducted by or on behalf of an agency of
  600  the state must be performed by an individual who has met the
  601  provision of subsection (2), except that the duration of the
  602  training program shall not exceed 120 hours of specific training
  603  for the type of property that such special state firesafety
  604  inspectors are assigned to inspect.
  605         (4) A firefighter certified pursuant to s. 633.35 may
  606  conduct firesafety inspections, under the supervision of a
  607  certified firesafety inspector, while on duty as a member of a
  608  fire department company conducting inservice firesafety
  609  inspections without being certified as a firesafety inspector,
  610  if such firefighter has satisfactorily completed an inservice
  611  fire department company inspector training program of at least
  612  24 hours’ duration as provided by rule of the department.
  613         (5) Every firesafety inspector or special state firesafety
  614  inspector certificate is valid for a period of 3 years from the
  615  date of issuance. Renewal of certification shall be subject to
  616  the affected person’s completing proper application for renewal
  617  and meeting all of the requirements for renewal as established
  618  under this chapter or by rule promulgated thereunder, which
  619  shall include completion of at least 40 hours during the
  620  preceding 3-year period of continuing education as required by
  621  the rule of the department or, in lieu thereof, successful
  622  passage of an examination as established by the department.
  623         (6) The State Fire Marshal may deny, refuse to renew,
  624  suspend, or revoke the certificate of a firesafety inspector or
  625  special state firesafety inspector if it finds that any of the
  626  following grounds exist:
  627         (a) Any cause for which issuance of a certificate could
  628  have been refused had it then existed and been known to the
  629  State Fire Marshal.
  630         (b) Violation of this chapter or any rule or order of the
  631  State Fire Marshal.
  632         (c) Falsification of records relating to the certificate.
  633         (d) Having been found guilty of or having pleaded guilty or
  634  nolo contendere to a felony, whether or not a judgment of
  635  conviction has been entered.
  636         (e) Failure to meet any of the renewal requirements.
  637         (f) Having been convicted of a crime in any jurisdiction
  638  which directly relates to the practice of fire code inspection,
  639  plan review, or administration.
  640         (g) Making or filing a report or record that the
  641  certificateholder knows to be false, or knowingly inducing
  642  another to file a false report or record, or knowingly failing
  643  to file a report or record required by state or local law, or
  644  knowingly impeding or obstructing such filing, or knowingly
  645  inducing another person to impede or obstruct such filing.
  646         (h) Failing to properly enforce applicable fire codes or
  647  permit requirements within this state which the
  648  certificateholder knows are applicable by committing willful
  649  misconduct, gross negligence, gross misconduct, repeated
  650  negligence, or negligence resulting in a significant danger to
  651  life or property.
  652         (i) Accepting labor, services, or materials at no charge or
  653  at a noncompetitive rate from any person who performs work that
  654  is under the enforcement authority of the certificateholder and
  655  who is not an immediate family member of the certificateholder.
  656  For the purpose of this paragraph, the term “immediate family
  657  member” means a spouse, child, parent, sibling, grandparent,
  658  aunt, uncle, or first cousin of the person or the person’s
  659  spouse or any person who resides in the primary residence of the
  660  certificateholder.
  661         (7) The department shall provide by rule for the
  662  certification of firesafety inspectors.
  663         Section 17. This act shall take effect July 1, 2009.
  664  
  665  ================= T I T L E  A M E N D M E N T ================
  666         And the title is amended as follows:
  667         Delete everything before the enacting clause
  668  and insert:
  669                       A bill to be entitled	                      
  670         An act relating to the inspection of nursing homes;
  671         amending ss. 381.0072, and 381.0098, F.S.; providing
  672         that nursing homes that are inspected by the Agency
  673         for Health Care Administration are exempt from
  674         inspection by the Department of Health; repealing s.
  675         400.0060(1), F.S., relating to the definition of the
  676         term “administrative assessment”; amending s.
  677         400.0061, F.S.; conforming provisions to changes made
  678         by the act relating to onsite administrative
  679         assessments; clarifying the authorization of an
  680         ombudsman to enter a long-term care facility; amending
  681         s. 400.0065, F.S.; clarifying that any person may make
  682         a complaint against a long-term care facility,
  683         including an employee of that facility; amending ss.
  684         400.0067, 400.0069, and 400.0071, F.S.; conforming
  685         provisions to changes made by the act relating to
  686         onsite administrative assessments; clarifying that any
  687         person may make a complaint against a long-term care
  688         facility, including an employee of that facility;
  689         repealing s. 400.0074, F.S., relating to onsite
  690         administrative assessments of nursing homes, assisted
  691         living facilities, and adult family-care homes
  692         conducted by the local ombudsman council; amending s.
  693         400.0075, F.S.; conforming provisions to changes made
  694         by the act relating to onsite administrative
  695         assessments; amending s. 400.19, F.S.; requiring the
  696         agency to conduct an inspection to determine
  697         compliance by the licensee with federal requirements;
  698         amending s. 400.191, F.S.; deleting provisions
  699         relating to a requirement that the agency make
  700         available to the public, distribute, and post reports
  701         and records concerning licensed nursing homes
  702         operating in the state; revising requirements for a
  703         nursing home facility licensee; amending s. 400.195,
  704         F.S.; revising provisions relating to agency reporting
  705         requirements; amending s. 400.23, F.S.; revising
  706         requirements for notification of deficiencies;
  707         revising the criteria for determining each class of
  708         deficiency; amending s. 465.017, F.S.; providing that
  709         nursing homes that are inspected by the agency are
  710         exempt from inspection by the Department of Health and
  711         imposition of a fee; amending s. 633.081, F.S.;
  712         providing that nursing homes that are inspected by the
  713         agency are exempt from inspection by the State Fire
  714         Marshal under certain circumstances; providing an
  715         effective date.