Florida Senate - 2009 COMMITTEE AMENDMENT
Bill No. SB 2286
Barcode 181138
LEGISLATIVE ACTION
Senate . House
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The Committee on Health Regulation (Gardiner) recommended the
following:
1 Senate Substitute for Amendment (705470) (with title
2 amendment)
3
4 Delete everything after the enacting clause
5 and insert:
6 Section 1. Section 395.0199, Florida Statutes, is repealed.
7 Section 2. Section 395.405, Florida Statutes, is amended to
8 read:
9 395.405 Rulemaking.—The department shall adopt and enforce
10 all rules necessary to administer ss. 395.0199, 395.401,
11 395.4015, 395.402, 395.4025, 395.403, 395.404, and 395.4045.
12 Section 3. Subsection (1) of section 400.0712, Florida
13 Statutes, is amended to read:
14 400.0712 Application for inactive license.—
15 (1) As specified in s. 408.831(4) and this section, the
16 agency may issue an inactive license to a nursing home facility
17 for all or a portion of its beds. Any request by a licensee that
18 a nursing home or portion of a nursing home become inactive must
19 be submitted to the agency in the approved format. The facility
20 may not initiate any suspension of services, notify residents,
21 or initiate inactivity before receiving approval from the
22 agency; and a licensee that violates this provision may not be
23 issued an inactive license.
24 Section 4. Subsection (2) of section 400.118, Florida
25 Statutes, is repealed.
26 Section 5. Section 400.141, Florida Statutes, is amended to
27 read:
28 400.141 Administration and management of nursing home
29 facilities.—
30 (1) Every licensed facility shall comply with all
31 applicable standards and rules of the agency and shall:
32 (a)(1) Be under the administrative direction and charge of
33 a licensed administrator.
34 (b)(2) Appoint a medical director licensed pursuant to
35 chapter 458 or chapter 459. The agency may establish by rule
36 more specific criteria for the appointment of a medical
37 director.
38 (c)(3) Have available the regular, consultative, and
39 emergency services of physicians licensed by the state.
40 (d)(4) Provide for resident use of a community pharmacy as
41 specified in s. 400.022(1)(q). Any other law to the contrary
42 notwithstanding, a registered pharmacist licensed in Florida,
43 that is under contract with a facility licensed under this
44 chapter or chapter 429, shall repackage a nursing facility
45 resident’s bulk prescription medication which has been packaged
46 by another pharmacist licensed in any state in the United States
47 into a unit dose system compatible with the system used by the
48 nursing facility, if the pharmacist is requested to offer such
49 service. In order to be eligible for the repackaging, a resident
50 or the resident’s spouse must receive prescription medication
51 benefits provided through a former employer as part of his or
52 her retirement benefits, a qualified pension plan as specified
53 in s. 4972 of the Internal Revenue Code, a federal retirement
54 program as specified under 5 C.F.R. s. 831, or a long-term care
55 policy as defined in s. 627.9404(1). A pharmacist who correctly
56 repackages and relabels the medication and the nursing facility
57 which correctly administers such repackaged medication under the
58 provisions of this paragraph may subsection shall not be held
59 liable in any civil or administrative action arising from the
60 repackaging. In order to be eligible for the repackaging, a
61 nursing facility resident for whom the medication is to be
62 repackaged shall sign an informed consent form provided by the
63 facility which includes an explanation of the repackaging
64 process and which notifies the resident of the immunities from
65 liability provided in this paragraph herein. A pharmacist who
66 repackages and relabels prescription medications, as authorized
67 under this paragraph subsection, may charge a reasonable fee for
68 costs resulting from the implementation of this provision.
69 (e)(5) Provide for the access of the facility residents to
70 dental and other health-related services, recreational services,
71 rehabilitative services, and social work services appropriate to
72 their needs and conditions and not directly furnished by the
73 licensee. When a geriatric outpatient nurse clinic is conducted
74 in accordance with rules adopted by the agency, outpatients
75 attending such clinic shall not be counted as part of the
76 general resident population of the nursing home facility, nor
77 shall the nursing staff of the geriatric outpatient clinic be
78 counted as part of the nursing staff of the facility, until the
79 outpatient clinic load exceeds 15 a day.
80 (f)(6) Be allowed and encouraged by the agency to provide
81 other needed services under certain conditions. If the facility
82 has a standard licensure status, and has had no class I or class
83 II deficiencies during the past 2 years or has been awarded a
84 Gold Seal under the program established in s. 400.235, it may be
85 encouraged by the agency to provide services, including, but not
86 limited to, respite and adult day services, which enable
87 individuals to move in and out of the facility. A facility is
88 not subject to any additional licensure requirements for
89 providing these services. Respite care may be offered to persons
90 in need of short-term or temporary nursing home services.
91 Respite care must be provided in accordance with this part and
92 rules adopted by the agency. However, the agency shall, by rule,
93 adopt modified requirements for resident assessment, resident
94 care plans, resident contracts, physician orders, and other
95 provisions, as appropriate, for short-term or temporary nursing
96 home services. The agency shall allow for shared programming and
97 staff in a facility which meets minimum standards and offers
98 services pursuant to this paragraph subsection, but, if the
99 facility is cited for deficiencies in patient care, may require
100 additional staff and programs appropriate to the needs of
101 service recipients. A person who receives respite care may not
102 be counted as a resident of the facility for purposes of the
103 facility’s licensed capacity unless that person receives 24-hour
104 respite care. A person receiving either respite care for 24
105 hours or longer or adult day services must be included when
106 calculating minimum staffing for the facility. Any costs and
107 revenues generated by a nursing home facility from
108 nonresidential programs or services shall be excluded from the
109 calculations of Medicaid per diems for nursing home
110 institutional care reimbursement.
111 (g)(7) If the facility has a standard license or is a Gold
112 Seal facility, exceeds the minimum required hours of licensed
113 nursing and certified nursing assistant direct care per resident
114 per day, and is part of a continuing care facility licensed
115 under chapter 651 or a retirement community that offers other
116 services pursuant to part III of this chapter or part I or part
117 III of chapter 429 on a single campus, be allowed to share
118 programming and staff. At the time of inspection and in the
119 semiannual report required pursuant to paragraph (o) subsection
120 (15), a continuing care facility or retirement community that
121 uses this option must demonstrate through staffing records that
122 minimum staffing requirements for the facility were met.
123 Licensed nurses and certified nursing assistants who work in the
124 nursing home facility may be used to provide services elsewhere
125 on campus if the facility exceeds the minimum number of direct
126 care hours required per resident per day and the total number of
127 residents receiving direct care services from a licensed nurse
128 or a certified nursing assistant does not cause the facility to
129 violate the staffing ratios required under s. 400.23(3)(a).
130 Compliance with the minimum staffing ratios shall be based on
131 total number of residents receiving direct care services,
132 regardless of where they reside on campus. If the facility
133 receives a conditional license, it may not share staff until the
134 conditional license status ends. This paragraph subsection does
135 not restrict the agency’s authority under federal or state law
136 to require additional staff if a facility is cited for
137 deficiencies in care which are caused by an insufficient number
138 of certified nursing assistants or licensed nurses. The agency
139 may adopt rules for the documentation necessary to determine
140 compliance with this provision.
141 (h)(8) Maintain the facility premises and equipment and
142 conduct its operations in a safe and sanitary manner.
143 (i)(9) If the licensee furnishes food service, provide a
144 wholesome and nourishing diet sufficient to meet generally
145 accepted standards of proper nutrition for its residents and
146 provide such therapeutic diets as may be prescribed by attending
147 physicians. In making rules to implement this paragraph
148 subsection, the agency shall be guided by standards recommended
149 by nationally recognized professional groups and associations
150 with knowledge of dietetics.
151 (j)(10) Keep full records of resident admissions and
152 discharges; medical and general health status, including medical
153 records, personal and social history, and identity and address
154 of next of kin or other persons who may have responsibility for
155 the affairs of the residents; and individual resident care plans
156 including, but not limited to, prescribed services, service
157 frequency and duration, and service goals. The records shall be
158 open to inspection by the agency.
159 (k)(11) Keep such fiscal records of its operations and
160 conditions as may be necessary to provide information pursuant
161 to this part.
162 (l)(12) Furnish copies of personnel records for employees
163 affiliated with such facility, to any other facility licensed by
164 this state requesting this information pursuant to this part.
165 Such information contained in the records may include, but is
166 not limited to, disciplinary matters and any reason for
167 termination. Any facility releasing such records pursuant to
168 this part shall be considered to be acting in good faith and may
169 not be held liable for information contained in such records,
170 absent a showing that the facility maliciously falsified such
171 records.
172 (m)(13) Publicly display a poster provided by the agency
173 containing the names, addresses, and telephone numbers for the
174 state’s abuse hotline, the State Long-Term Care Ombudsman, the
175 Agency for Health Care Administration consumer hotline, the
176 Advocacy Center for Persons with Disabilities, the Florida
177 Statewide Advocacy Council, and the Medicaid Fraud Control Unit,
178 with a clear description of the assistance to be expected from
179 each.
180 (n)(14) Submit to the agency the information specified in
181 s. 400.071(1)(b) for a management company within 30 days after
182 the effective date of the management agreement.
183 (o)1.(15) Submit semiannually to the agency, or more
184 frequently if requested by the agency, information regarding
185 facility staff-to-resident ratios, staff turnover, and staff
186 stability, including information regarding certified nursing
187 assistants, licensed nurses, the director of nursing, and the
188 facility administrator. For purposes of this reporting:
189 a.(a) Staff-to-resident ratios must be reported in the
190 categories specified in s. 400.23(3)(a) and applicable rules.
191 The ratio must be reported as an average for the most recent
192 calendar quarter.
193 b.(b) Staff turnover must be reported for the most recent
194 12-month period ending on the last workday of the most recent
195 calendar quarter prior to the date the information is submitted.
196 The turnover rate must be computed quarterly, with the annual
197 rate being the cumulative sum of the quarterly rates. The
198 turnover rate is the total number of terminations or separations
199 experienced during the quarter, excluding any employee
200 terminated during a probationary period of 3 months or less,
201 divided by the total number of staff employed at the end of the
202 period for which the rate is computed, and expressed as a
203 percentage.
204 c.(c) The formula for determining staff stability is the
205 total number of employees that have been employed for more than
206 12 months, divided by the total number of employees employed at
207 the end of the most recent calendar quarter, and expressed as a
208 percentage.
209 d.(d) A nursing facility that has failed to comply with
210 state minimum-staffing requirements for 2 consecutive days is
211 prohibited from accepting new admissions until the facility has
212 achieved the minimum-staffing requirements for a period of 6
213 consecutive days. For the purposes of this sub-subparagraph
214 paragraph, any person who was a resident of the facility and was
215 absent from the facility for the purpose of receiving medical
216 care at a separate location or was on a leave of absence is not
217 considered a new admission. Failure to impose such an admissions
218 moratorium constitutes a class II deficiency.
219 e.(e) A nursing facility which does not have a conditional
220 license may be cited for failure to comply with the standards in
221 s. 400.23(3)(a)1.a. only if it has failed to meet those
222 standards on 2 consecutive days or if it has failed to meet at
223 least 97 percent of those standards on any one day.
224 f.(f) A facility which has a conditional license must be in
225 compliance with the standards in s. 400.23(3)(a) at all times.
226
227 2. Nothing in This paragraph does not section shall limit
228 the agency’s ability to impose a deficiency or take other
229 actions if a facility does not have enough staff to meet the
230 residents’ needs.
231 (16) Report monthly the number of vacant beds in the
232 facility which are available for resident occupancy on the day
233 the information is reported.
234 (p)(17) Notify a licensed physician when a resident
235 exhibits signs of dementia or cognitive impairment or has a
236 change of condition in order to rule out the presence of an
237 underlying physiological condition that may be contributing to
238 such dementia or impairment. The notification must occur within
239 30 days after the acknowledgment of such signs by facility
240 staff. If an underlying condition is determined to exist, the
241 facility shall arrange, with the appropriate health care
242 provider, the necessary care and services to treat the
243 condition.
244 (q)(18) If the facility implements a dining and hospitality
245 attendant program, ensure that the program is developed and
246 implemented under the supervision of the facility director of
247 nursing. A licensed nurse, licensed speech or occupational
248 therapist, or a registered dietitian must conduct training of
249 dining and hospitality attendants. A person employed by a
250 facility as a dining and hospitality attendant must perform
251 tasks under the direct supervision of a licensed nurse.
252 (r)(19) Report to the agency any filing for bankruptcy
253 protection by the facility or its parent corporation,
254 divestiture or spin-off of its assets, or corporate
255 reorganization within 30 days after the completion of such
256 activity.
257 (s)(20) Maintain general and professional liability
258 insurance coverage that is in force at all times. In lieu of
259 general and professional liability insurance coverage, a state
260 designated teaching nursing home and its affiliated assisted
261 living facilities created under s. 430.80 may demonstrate proof
262 of financial responsibility as provided in s. 430.80(3)(h).
263 (t)(21) Maintain in the medical record for each resident a
264 daily chart of certified nursing assistant services provided to
265 the resident. The certified nursing assistant who is caring for
266 the resident must complete this record by the end of his or her
267 shift. This record must indicate assistance with activities of
268 daily living, assistance with eating, and assistance with
269 drinking, and must record each offering of nutrition and
270 hydration for those residents whose plan of care or assessment
271 indicates a risk for malnutrition or dehydration.
272 (u)(22) Before November 30 of each year, subject to the
273 availability of an adequate supply of the necessary vaccine,
274 provide for immunizations against influenza viruses to all its
275 consenting residents in accordance with the recommendations of
276 the United States Centers for Disease Control and Prevention,
277 subject to exemptions for medical contraindications and
278 religious or personal beliefs. Subject to these exemptions, any
279 consenting person who becomes a resident of the facility after
280 November 30 but before March 31 of the following year must be
281 immunized within 5 working days after becoming a resident.
282 Immunization shall not be provided to any resident who provides
283 documentation that he or she has been immunized as required by
284 this paragraph subsection. This paragraph subsection does not
285 prohibit a resident from receiving the immunization from his or
286 her personal physician if he or she so chooses. A resident who
287 chooses to receive the immunization from his or her personal
288 physician shall provide proof of immunization to the facility.
289 The agency may adopt and enforce any rules necessary to comply
290 with or implement this subsection.
291 (v)(23) Assess all residents for eligibility for
292 pneumococcal polysaccharide vaccination (PPV) and vaccinate
293 residents when indicated within 60 days after the effective date
294 of this act in accordance with the recommendations of the United
295 States Centers for Disease Control and Prevention, subject to
296 exemptions for medical contraindications and religious or
297 personal beliefs. Residents admitted after the effective date of
298 this act shall be assessed within 5 working days of admission
299 and, when indicated, vaccinated within 60 days in accordance
300 with the recommendations of the United States Centers for
301 Disease Control and Prevention, subject to exemptions for
302 medical contraindications and religious or personal beliefs.
303 Immunization shall not be provided to any resident who provides
304 documentation that he or she has been immunized as required by
305 this paragraph subsection. This paragraph subsection does not
306 prohibit a resident from receiving the immunization from his or
307 her personal physician if he or she so chooses. A resident who
308 chooses to receive the immunization from his or her personal
309 physician shall provide proof of immunization to the facility.
310 The agency may adopt and enforce any rules necessary to comply
311 with or implement this paragraph subsection.
312 (w)(24) Annually encourage and promote to its employees the
313 benefits associated with immunizations against influenza viruses
314 in accordance with the recommendations of the United States
315 Centers for Disease Control and Prevention. The agency may adopt
316 and enforce any rules necessary to comply with or implement this
317 paragraph subsection.
318 (2) Facilities that have been awarded a Gold Seal under the
319 program established in s. 400.235 may develop a plan to provide
320 certified nursing assistant training as prescribed by federal
321 regulations and state rules and may apply to the agency for
322 approval of their program.
323 Section 6. Subsections (5), (9), (10), (11), (12), (13),
324 (14), and (15) of section 400.147, Florida Statutes, are amended
325 to read:
326 400.147 Internal risk management and quality assurance
327 program.—
328 (5) For purposes of reporting to the agency under this
329 section, the term “adverse incident” means:
330 (a) An event over which facility personnel could exercise
331 control and which is associated in whole or in part with the
332 facility’s intervention, rather than the condition for which
333 such intervention occurred, and which results in one of the
334 following:
335 1. Death;
336 2. Brain or spinal damage;
337 3. Permanent disfigurement;
338 4. Fracture or dislocation of bones or joints;
339 5. A limitation of neurological, physical, or sensory
340 function;
341 6. Any condition that required medical attention to which
342 the resident has not given his or her informed consent,
343 including failure to honor advanced directives; or
344 7. Any condition that required the transfer of the
345 resident, within or outside the facility, to a unit providing a
346 more acute level of care due to the adverse incident, rather
347 than the resident’s condition prior to the adverse incident; or
348 8. An event that is reported to law enforcement or its
349 personnel for investigation; or
350 (b) Abuse, neglect, or exploitation as defined in s.
351 415.102;
352 (c) Abuse, neglect and harm as defined in s. 39.01;
353 (b)(d) Resident elopement, if the elopement places the
354 resident at risk of harm or injury.; or
355 (e) An event that is reported to law enforcement.
356 (9) Abuse, neglect, or exploitation must be reported to the
357 agency as required by 42 C.F.R. s. 483.13(c) and to the
358 department as required by chapters 39 and 415.
359 (10)(9) By the 10th of each month, each facility subject to
360 this section shall report any notice received pursuant to s.
361 400.0233(2) and each initial complaint that was filed with the
362 clerk of the court and served on the facility during the
363 previous month by a resident or a resident’s family member,
364 guardian, conservator, or personal legal representative. The
365 report must include the name of the resident, the resident’s
366 date of birth and social security number, the Medicaid
367 identification number for Medicaid-eligible persons, the date or
368 dates of the incident leading to the claim or dates of
369 residency, if applicable, and the type of injury or violation of
370 rights alleged to have occurred. Each facility shall also submit
371 a copy of the notices received pursuant to s. 400.0233(2) and
372 complaints filed with the clerk of the court. This report is
373 confidential as provided by law and is not discoverable or
374 admissible in any civil or administrative action, except in such
375 actions brought by the agency to enforce the provisions of this
376 part.
377 (11)(10) The agency shall review, as part of its licensure
378 inspection process, the internal risk management and quality
379 assurance program at each facility regulated by this section to
380 determine whether the program meets standards established in
381 statutory laws and rules, is being conducted in a manner
382 designed to reduce adverse incidents, and is appropriately
383 reporting incidents as required by this section.
384 (12)(11) There is no monetary liability on the part of, and
385 a cause of action for damages may not arise against, any risk
386 manager for the implementation and oversight of the internal
387 risk management and quality assurance program in a facility
388 licensed under this part as required by this section, or for any
389 act or proceeding undertaken or performed within the scope of
390 the functions of such internal risk management and quality
391 assurance program if the risk manager acts without intentional
392 fraud.
393 (13)(12) If the agency, through its receipt of the adverse
394 incident reports prescribed in subsection (7), or through any
395 investigation, has a reasonable belief that conduct by a staff
396 member or employee of a facility is grounds for disciplinary
397 action by the appropriate regulatory board, the agency shall
398 report this fact to the regulatory board.
399 (14)(13) The agency may adopt rules to administer this
400 section.
401 (14) The agency shall annually submit to the Legislature a
402 report on nursing home adverse incidents. The report must
403 include the following information arranged by county:
404 (a) The total number of adverse incidents.
405 (b) A listing, by category, of the types of adverse
406 incidents, the number of incidents occurring within each
407 category, and the type of staff involved.
408 (c) A listing, by category, of the types of injury caused
409 and the number of injuries occurring within each category.
410 (d) Types of liability claims filed based on an adverse
411 incident or reportable injury.
412 (e) Disciplinary action taken against staff, categorized by
413 type of staff involved.
414 (15) Information gathered by a credentialing organization
415 under a quality assurance program is not discoverable from the
416 credentialing organization. This subsection does not limit
417 discovery of, access to, or use of facility records, including
418 those records from which the credentialing organization gathered
419 its information.
420 Section 7. Subsection (3) of section 400.162, Florida
421 Statutes, is amended to read:
422 400.162 Property and personal affairs of residents.—
423 (3) A licensee shall provide for the safekeeping of
424 personal effects, funds, and other property of the resident in
425 the facility. Whenever necessary for the protection of
426 valuables, or in order to avoid unreasonable responsibility
427 therefor, the licensee may require that such valuables be
428 excluded or removed from the facility and kept at some place not
429 subject to the control of the licensee. At the request of a
430 resident, the facility shall mark the resident’s personal
431 property with the resident’s name or another type of
432 identification, without defacing the property. Any theft or loss
433 of a resident’s personal property shall be documented by the
434 facility. The facility shall develop policies and procedures to
435 minimize the risk of theft or loss of the personal property of
436 residents. A copy of the policy shall be provided to every
437 employee and to each resident and the resident’s representative
438 if appropriate at admission and when revised. Facility policies
439 must include provisions related to reporting theft or loss of a
440 resident’s property to law enforcement and any facility waiver
441 of liability for loss or theft. The facility shall post notice
442 of these policies and procedures, and any revision thereof, in
443 places accessible to residents.
444 Section 8. Paragraph (d) of subsection (1) of section
445 400.195, Florida Statutes, is amended to read:
446 400.195 Agency reporting requirements.—
447 (1) For the period beginning June 30, 2001, and ending June
448 30, 2005, the Agency for Health Care Administration shall
449 provide a report to the Governor, the President of the Senate,
450 and the Speaker of the House of Representatives with respect to
451 nursing homes. The first report shall be submitted no later than
452 December 30, 2002, and subsequent reports shall be submitted
453 every 6 months thereafter. The report shall identify facilities
454 based on their ownership characteristics, size, business
455 structure, for-profit or not-for-profit status, and any other
456 characteristics the agency determines useful in analyzing the
457 varied segments of the nursing home industry and shall report:
458 (d) Information regarding deficiencies cited, including
459 information used to develop the Nursing Home Guide WATCH LIST
460 pursuant to s. 400.191, and applicable rules, a summary of data
461 generated on nursing homes by Centers for Medicare and Medicaid
462 Services Nursing Home Quality Information Project, and
463 information collected pursuant to s. 400.147(10) s. 400.147(9),
464 relating to litigation.
465 Section 9. Subsection (3) of section 400.23, Florida
466 Statutes, is amended to read:
467 400.23 Rules; evaluation and deficiencies; licensure
468 status.—
469 (3)(a)1. The agency shall adopt rules providing minimum
470 staffing requirements for nursing homes. These requirements
471 shall include, for each nursing home facility:
472 a. A minimum certified nursing assistant staffing of 2.6
473 hours of direct care per resident per day beginning January 1,
474 2003, and increasing to 2.7 hours of direct care per resident
475 per day beginning January 1, 2007. Beginning January 1, 2002, no
476 facility shall staff below one certified nursing assistant per
477 20 residents, and a minimum licensed nursing staffing of 1.0
478 hour of direct care per resident per day but never below one
479 licensed nurse per 40 residents.
480 b. Beginning January 1, 2007, a minimum weekly average
481 certified nursing assistant staffing of 2.9 hours of direct care
482 per resident per day. For the purpose of this sub-subparagraph,
483 a week is defined as Sunday through Saturday.
484 2. Nursing assistants employed under s. 400.211(2) may be
485 included in computing the staffing ratio for certified nursing
486 assistants only if their job responsibilities include only
487 nursing-assistant-related duties.
488 3. Each nursing home must document compliance with staffing
489 standards as required under this paragraph and post daily the
490 names of staff on duty for the benefit of facility residents and
491 the public.
492 4. The agency shall recognize the use of licensed nurses
493 for compliance with minimum staffing requirements for certified
494 nursing assistants, provided that the facility otherwise meets
495 the minimum staffing requirements for licensed nurses and that
496 the licensed nurses are performing the duties of a certified
497 nursing assistant. Unless otherwise approved by the agency,
498 licensed nurses counted toward the minimum staffing requirements
499 for certified nursing assistants must exclusively perform the
500 duties of a certified nursing assistant for the entire shift and
501 not also be counted toward the minimum staffing requirements for
502 licensed nurses. If the agency approved a facility’s request to
503 use a licensed nurse to perform both licensed nursing and
504 certified nursing assistant duties, the facility must allocate
505 the amount of staff time specifically spent on certified nursing
506 assistant duties for the purpose of documenting compliance with
507 minimum staffing requirements for certified and licensed nursing
508 staff. In no event may the hours of a licensed nurse with dual
509 job responsibilities be counted twice.
510 (b) The agency shall adopt rules to allow properly trained
511 staff of a nursing facility, in addition to certified nursing
512 assistants and licensed nurses, to assist residents with eating.
513 The rules shall specify the minimum training requirements and
514 shall specify the physiological conditions or disorders of
515 residents which would necessitate that the eating assistance be
516 provided by nursing personnel of the facility. Nonnursing staff
517 providing eating assistance to residents under the provisions of
518 this subsection shall not count toward compliance with minimum
519 staffing standards.
520 (c) Licensed practical nurses licensed under chapter 464
521 who are providing nursing services in nursing home facilities
522 under this part may supervise the activities of other licensed
523 practical nurses, certified nursing assistants, and other
524 unlicensed personnel providing services in such facilities in
525 accordance with rules adopted by the Board of Nursing.
526 Section 10. Paragraph (a) of subsection (15) of section
527 400.506, Florida Statutes, is amended to read:
528 400.506 Licensure of nurse registries; requirements;
529 penalties.—
530 (15)(a) The agency may deny, suspend, or revoke the license
531 of a nurse registry and shall impose a fine of $5,000 against a
532 nurse registry that:
533 1. Provides services to residents in an assisted living
534 facility for which the nurse registry does not receive fair
535 market value remuneration.
536 2. Provides staffing to an assisted living facility for
537 which the nurse registry does not receive fair market value
538 remuneration.
539 3. Fails to provide the agency, upon request, with copies
540 of all contracts with assisted living facilities which were
541 executed within the last 5 years.
542 4. Gives remuneration to a case manager, discharge planner,
543 facility-based staff member, or third-party vendor who is
544 involved in the discharge planning process of a facility
545 licensed under chapter 395 or this chapter and from whom the
546 nurse registry receives referrals, except that this subparagraph
547 does not apply to a nurse registry that does not participate in
548 the Medicaid or Medicare program.
549 5. Gives remuneration to a physician, a member of the
550 physician’s office staff, or an immediate family member of the
551 physician, and the nurse registry received a patient referral in
552 the last 12 months from that physician or the physician’s office
553 staff, except that this subparagraph does not apply to a nurse
554 registry that does not participate in the Medicaid or Medicare
555 program.
556 Section 11. Paragraph (a) of subsection (7) of section
557 400.9935, Florida Statutes, is amended to read:
558 400.9935 Clinic responsibilities.—
559 (7)(a) Each clinic engaged in magnetic resonance imaging
560 services must be accredited by the Joint Commission on
561 Accreditation of Healthcare Organizations, the American College
562 of Radiology, or the Accreditation Association for Ambulatory
563 Health Care, within 1 year after licensure. A clinic that is
564 accredited by the American College of Radiology or is within the
565 original 1-year period after licensure and replaces its core
566 magnetic resonance imaging equipment shall be given 1 year after
567 the date on which the equipment is replaced to attain
568 accreditation. However, a clinic may request a single, 6-month
569 extension if it provides evidence to the agency establishing
570 that, for good cause shown, such clinic cannot can not be
571 accredited within 1 year after licensure, and that such
572 accreditation will be completed within the 6-month extension.
573 After obtaining accreditation as required by this subsection,
574 each such clinic must maintain accreditation as a condition of
575 renewal of its license. A clinic that files a change of
576 ownership application must comply with the original
577 accreditation timeframe requirements of the transferor. The
578 agency shall deny a change of ownership application if the
579 clinic is not in compliance with the accreditation requirements.
580 When a clinic adds, replaces, or modifies magnetic resonance
581 imaging equipment and the accreditation agency requires new
582 accreditation, the clinic must be accredited within 1 year after
583 the date of the addition, replacement, or modification but may
584 request a single, 6-month extension if the clinic provides
585 evidence of good cause to the agency.
586 Section 12. Subsection (6) of section 400.995, Florida
587 Statutes, is amended to read:
588 400.995 Agency administrative penalties.—
589 (6) During an inspection, the agency, as an alternative to
590 or in conjunction with an administrative action against a clinic
591 for violations of this part and adopted rules, shall make a
592 reasonable attempt to discuss each violation and recommended
593 corrective action with the owner, medical director, or clinic
594 director of the clinic, prior to written notification. The
595 agency, instead of fixing a period within which the clinic shall
596 enter into compliance with standards, may request a plan of
597 corrective action from the clinic which demonstrates a good
598 faith effort to remedy each violation by a specific date,
599 subject to the approval of the agency.
600 Section 13. Subsections (5) and (9) of section 408.803,
601 Florida Statutes, are amended to read:
602 408.803 Definitions.—As used in this part, the term:
603 (5) “Change of ownership” means:
604 (a) An event in which the licensee sells or otherwise
605 transfers its ownership changes to a different individual or
606 legal entity as evidenced by a change in federal employer
607 identification number or taxpayer identification number; or
608 (b) An event in which 51 45 percent or more of the
609 ownership, voting shares, membership, or controlling interest of
610 a licensee is in any manner transferred or otherwise assigned.
611 This paragraph does not apply to a licensee that is publicly
612 traded on a recognized stock exchange in a corporation whose
613 shares are not publicly traded on a recognized stock exchange is
614 transferred or assigned, including the final transfer or
615 assignment of multiple transfers or assignments over a 2-year
616 period that cumulatively total 45 percent or greater.
617
618 A change solely in the management company or board of directors
619 is not a change of ownership.
620 (9) “Licensee” means an individual, corporation,
621 partnership, firm, association, or governmental entity, or other
622 entity that is issued a permit, registration, certificate, or
623 license by the agency. The licensee is legally responsible for
624 all aspects of the provider operation.
625 Section 14. Paragraph (a) of subsection (1), subsection
626 (2), paragraph (c) of subsection (7), and subsection (8) of
627 section 408.806, Florida Statutes, are amended to read:
628 408.806 License application process.—
629 (1) An application for licensure must be made to the agency
630 on forms furnished by the agency, submitted under oath, and
631 accompanied by the appropriate fee in order to be accepted and
632 considered timely. The application must contain information
633 required by authorizing statutes and applicable rules and must
634 include:
635 (a) The name, address, and social security number of:
636 1. The applicant;
637 2. The administrator or a similarly titled person who is
638 responsible for the day-to-day operation of the provider;
639 3. The financial officer or similarly titled person who is
640 responsible for the financial operation of the licensee or
641 provider; and
642 4. Each controlling interest if the applicant or
643 controlling interest is an individual.
644 (2)(a) The applicant for a renewal license must submit an
645 application that must be received by the agency at least 60 days
646 but no more than 120 days before prior to the expiration of the
647 current license. An application received more than 120 days
648 before the expiration of the current license shall be returned
649 to the applicant. If the renewal application and fee are
650 received prior to the license expiration date, the license shall
651 not be deemed to have expired if the license expiration date
652 occurs during the agency’s review of the renewal application.
653 (b) The applicant for initial licensure due to a change of
654 ownership must submit an application that must be received by
655 the agency at least 60 days prior to the date of change of
656 ownership.
657 (c) For any other application or request, the applicant
658 must submit an application or request that must be received by
659 the agency at least 60 days but no more than 120 days before
660 prior to the requested effective date, unless otherwise
661 specified in authorizing statutes or applicable rules. An
662 application received more than 120 days before the requested
663 effective date shall be returned to the applicant.
664 (d) The agency shall notify the licensee by mail or
665 electronically at least 90 days before prior to the expiration
666 of a license that a renewal license is necessary to continue
667 operation. The failure to timely submit a renewal application
668 and license fee shall result in a $50 per day late fee charged
669 to the licensee by the agency; however, the aggregate amount of
670 the late fee may not exceed 50 percent of the licensure fee or
671 $500, whichever is less. If an application is received after the
672 required filing date and exhibits a hand-canceled postmark
673 obtained from a United States post office dated on or before the
674 required filing date, no fine will be levied.
675 (7)
676 (c) If an inspection is required by the authorizing statute
677 for a license application other than an initial application, the
678 inspection must be unannounced. This paragraph does not apply to
679 inspections required pursuant to ss. 383.324, 395.0161(4),
680 429.67(6), and 483.061(2).
681 (8) The agency may establish procedures for the electronic
682 notification and submission of required information, including,
683 but not limited to:
684 (a) Licensure applications.
685 (b) Required signatures.
686 (c) Payment of fees.
687 (d) Notarization of applications.
688
689 Requirements for electronic submission of any documents required
690 by this part or authorizing statutes may be established by rule.
691 As an alternative to sending documents as required by
692 authorizing statutes, the agency may provide electronic access
693 to information or documents.
694 Section 15. Subsection (2) of section 408.808, Florida
695 Statutes, is amended to read:
696 408.808 License categories.—
697 (2) PROVISIONAL LICENSE.—A provisional license may be
698 issued to an applicant pursuant to s. 408.809(3). An applicant
699 against whom a proceeding denying or revoking a license is
700 pending at the time of license renewal may be issued a
701 provisional license effective until final action not subject to
702 further appeal. A provisional license may also be issued to an
703 applicant applying for a change of ownership. A provisional
704 license shall be limited in duration to a specific period of
705 time, not to exceed 12 months, as determined by the agency.
706 Section 16. Subsection (5) of section 408.809, Florida
707 Statutes, is amended, and subsection (6) is added to that
708 section, to read:
709 408.809 Background screening; prohibited offenses.—
710 (5) Effective October 1, 2009, in addition to the offenses
711 listed in ss. 435.03 and 435.04, all persons required to undergo
712 background screening pursuant to this part or authorizing
713 statutes must not have been found guilty of, regardless of
714 adjudication, or entered a plea of nolo contendere or guilty to,
715 any of the following offenses or any similar offense of another
716 jurisdiction:
717 (a) Any authorizing statutes, if the offense was a felony.
718 (b) This chapter, if the offense was a felony.
719 (c) Section 409.920, relating to Medicaid provider fraud,
720 if the offense was a felony.
721 (d) Section 409.9201, relating to Medicaid fraud, if the
722 offense was a felony.
723 (e) Section 741.28, relating to domestic violence.
724 (f) Chapter 784, relating to assault, battery, and culpable
725 negligence, if the offense was a felony.
726 (g) Section 810.02, relating to burglary.
727 (h) Section 817.034, relating to fraudulent acts through
728 mail, wire, radio, electromagnetic, photoelectronic, or
729 photooptical systems.
730 (i) Section 817.234, relating to false and fraudulent
731 insurance claims.
732 (j) Section 817.505, relating to patient brokering.
733 (k) Section 817.568, relating to criminal use of personal
734 identification information.
735 (l) Section 817.60, relating to obtaining a credit card
736 through fraudulent means.
737 (m) Section 817.61, relating to fraudulent use of credit
738 cards, if the offense was a felony.
739 (n) Section 831.01, relating to forgery.
740 (o) Section 831.02, relating to uttering forged
741 instruments.
742 (p) Section 831.07, relating to forging bank bills, checks,
743 drafts, or promissory notes.
744 (q) Section 831.09, relating to uttering forged bank bills,
745 checks, drafts, or promissory notes.
746 (r) Section 831.30, relating to fraud in obtaining
747 medicinal drugs.
748 (s) Section 831.31, relating to the sale, manufacture,
749 delivery, or possession with the intent to sell, manufacture, or
750 deliver any counterfeit controlled substance, if the offense was
751 a felony.
752
753 A person who serves as a controlling interest of or is employed
754 by a licensee on September 30, 2009, is not required by law to
755 submit to rescreening if that licensee has in its possession
756 written evidence that the person has been screened and qualified
757 according to the standards specified in s. 435.03 or s. 435.04.
758 However, if such person has a disqualifying offense listed in
759 this section, he or she may apply for an exemption from the
760 appropriate licensing agency before September 30, 2009, and if
761 agreed to by the employer, may continue to perform his or her
762 duties until the licensing agency renders a decision on the
763 application for exemption for offenses listed in this section.
764 Exemptions from disqualification may be granted pursuant to s.
765 435.07. Background screening is not required to obtain a
766 certificate of exemption issued under s. 483.106.
767 (6) The attestations required under ss. 435.04(5) and
768 435.05(3) must be submitted at the time of license renewal,
769 notwithstanding the provisions of ss. 435.04(5) and 435.05(3)
770 which require annual submission of an affidavit of compliance
771 with background screening requirements.
772 Section 17. Subsection (3) of section 408.810, Florida
773 Statutes, is amended to read:
774 408.810 Minimum licensure requirements.—In addition to the
775 licensure requirements specified in this part, authorizing
776 statutes, and applicable rules, each applicant and licensee must
777 comply with the requirements of this section in order to obtain
778 and maintain a license.
779 (3) Unless otherwise specified in this part, authorizing
780 statutes, or applicable rules, any information required to be
781 reported to the agency must be submitted within 21 calendar days
782 after the report period or effective date of the information,
783 whichever is earlier, including, but not limited to, any change
784 of:
785 (a) Information contained in the most recent application
786 for licensure.
787 (b) Required insurance or bonds.
788 Section 18. Section 408.811, Florida Statutes, is amended
789 to read:
790 408.811 Right of inspection; copies; inspection reports;
791 plan for correction of deficiencies.—
792 (1) An authorized officer or employee of the agency may
793 make or cause to be made any inspection or investigation deemed
794 necessary by the agency to determine the state of compliance
795 with this part, authorizing statutes, and applicable rules. The
796 right of inspection extends to any business that the agency has
797 reason to believe is being operated as a provider without a
798 license, but inspection of any business suspected of being
799 operated without the appropriate license may not be made without
800 the permission of the owner or person in charge unless a warrant
801 is first obtained from a circuit court. Any application for a
802 license issued under this part, authorizing statutes, or
803 applicable rules constitutes permission for an appropriate
804 inspection to verify the information submitted on or in
805 connection with the application.
806 (a) All inspections shall be unannounced, except as
807 specified in s. 408.806.
808 (b) Inspections for relicensure shall be conducted
809 biennially unless otherwise specified by authorizing statutes or
810 applicable rules.
811 (2) Inspections conducted in conjunction with
812 certification, comparable licensure requirements, or a
813 recognized or approved accreditation organization may be
814 accepted in lieu of a complete licensure inspection. However, a
815 licensure inspection may also be conducted to review any
816 licensure requirements that are not also requirements for
817 certification.
818 (3) The agency shall have access to and the licensee shall
819 provide, or if requested send, copies of all provider records
820 required during an inspection or other review at no cost to the
821 agency, including records requested during an offsite review.
822 (4) A deficiency must be corrected within 30 calendar days
823 after the provider is notified of inspection results unless an
824 alternative timeframe is required or approved by the agency.
825 (5) The agency may require an applicant or licensee to
826 submit a plan of correction for deficiencies. If required, the
827 plan of correction must be filed with the agency within 10
828 calendar days after notification unless an alternative timeframe
829 is required.
830 (6)(a)(4)(a) Each licensee shall maintain as public
831 information, available upon request, records of all inspection
832 reports pertaining to that provider that have been filed by the
833 agency unless those reports are exempt from or contain
834 information that is exempt from s. 119.07(1) and s. 24(a), Art.
835 I of the State Constitution or is otherwise made confidential by
836 law. Effective October 1, 2006, copies of such reports shall be
837 retained in the records of the provider for at least 3 years
838 following the date the reports are filed and issued, regardless
839 of a change of ownership.
840 (b) A licensee shall, upon the request of any person who
841 has completed a written application with intent to be admitted
842 by such provider, any person who is a client of such provider,
843 or any relative, spouse, or guardian of any such person, furnish
844 to the requester a copy of the last inspection report pertaining
845 to the licensed provider that was issued by the agency or by an
846 accrediting organization if such report is used in lieu of a
847 licensure inspection.
848 Section 19. Section 408.813, Florida Statutes, is amended
849 to read:
850 408.813 Administrative fines; violations.—As a penalty for
851 any violation of this part, authorizing statutes, or applicable
852 rules, the agency may impose an administrative fine.
853 (1) Unless the amount or aggregate limitation of the fine
854 is prescribed by authorizing statutes or applicable rules, the
855 agency may establish criteria by rule for the amount or
856 aggregate limitation of administrative fines applicable to this
857 part, authorizing statutes, and applicable rules. Each day of
858 violation constitutes a separate violation and is subject to a
859 separate fine. For fines imposed by final order of the agency
860 and not subject to further appeal, the violator shall pay the
861 fine plus interest at the rate specified in s. 55.03 for each
862 day beyond the date set by the agency for payment of the fine.
863 (2) Violations of this part, authorizing statutes, or
864 applicable rules shall be classified according to the nature of
865 the violation and the gravity of its probable effect on clients.
866 The scope of a violation may be cited as an isolated, patterned,
867 or widespread deficiency. An isolated deficiency is a deficiency
868 affecting one or a very limited number of clients, or involving
869 one or a very limited number of staff, or a situation that
870 occurred only occasionally or in a very limited number of
871 locations. A patterned deficiency is a deficiency in which more
872 than a very limited number of clients are affected, or more than
873 a very limited number of staff are involved, or the situation
874 has occurred in several locations, or the same client or clients
875 have been affected by repeated occurrences of the same deficient
876 practice but the effect of the deficient practice is not found
877 to be pervasive throughout the provider. A widespread deficiency
878 is a deficiency in which the problems causing the deficiency are
879 pervasive in the provider or represent systemic failure that has
880 affected or has the potential to affect a large portion of the
881 provider’s clients. This subsection does not affect the
882 legislative determination of the amount of a fine imposed under
883 authorizing statutes. Violations shall be classified on the
884 written notice as follows:
885 (a) Class “I” violations are those conditions or
886 occurrences related to the operation and maintenance of a
887 provider or to the care of clients which the agency determines
888 present an imminent danger to the clients of the provider or a
889 substantial probability that death or serious physical or
890 emotional harm would result therefrom. The condition or practice
891 constituting a class I violation shall be abated or eliminated
892 within 24 hours, unless a fixed period, as determined by the
893 agency, is required for correction. The agency shall impose an
894 administrative fine as provided by law for a cited class I
895 violation. A fine shall be levied notwithstanding the correction
896 of the violation.
897 (b) Class “II” violations are those conditions or
898 occurrences related to the operation and maintenance of a
899 provider or to the care of clients which the agency determines
900 directly threaten the physical or emotional health, safety, or
901 security of the clients, other than class I violations. The
902 agency shall impose an administrative fine as provided by law
903 for a cited class II violation. A fine shall be levied
904 notwithstanding the correction of the violation.
905 (c) Class “III” violations are those conditions or
906 occurrences related to the operation and maintenance of a
907 provider or to the care of clients which the agency determines
908 indirectly or potentially threaten the physical or emotional
909 health, safety, or security of clients, other than class I or
910 class II violations. The agency shall impose an administrative
911 fine as provided in this section for a cited class III
912 violation. A citation for a class III violation must specify the
913 time within which the violation is required to be corrected. If
914 a class III violation is corrected within the time specified, a
915 fine may not be imposed.
916 (d) Class “IV” violations are those conditions or
917 occurrences related to the operation and maintenance of a
918 provider or to required reports, forms, or documents that do not
919 have the potential of negatively affecting clients. These
920 violations are of a type that the agency determines do not
921 threaten the health, safety, or security of clients. The agency
922 shall impose an administrative fine as provided in this section
923 for a cited class IV violation. A citation for a class IV
924 violation must specify the time within which the violation is
925 required to be corrected. If a class IV violation is corrected
926 within the time specified, a fine may not be imposed.
927 Section 20. Subsections (11), (12), (13), (14), (15), (16),
928 (17), (18), (19), (20), (21), (22), (23), (24), (25), (26),
929 (27), (28), and (29) of section 408.820, Florida Statutes, are
930 amended to read:
931 408.820 Exemptions.—Except as prescribed in authorizing
932 statutes, the following exemptions shall apply to specified
933 requirements of this part:
934 (11) Private review agents, as provided under part I of
935 chapter 395, are exempt from ss. 408.806(7), 408.810, and
936 408.811.
937 (11)(12) Health care risk managers, as provided under part
938 I of chapter 395, are exempt from ss. 408.806(7), 408.810(4)
939 (10) 408.810, and 408.811.
940 (12)(13) Nursing homes, as provided under part II of
941 chapter 400, are exempt from s. 408.810(7).
942 (13)(14) Assisted living facilities, as provided under part
943 I of chapter 429, are exempt from s. 408.810(10).
944 (14)(15) Home health agencies, as provided under part III
945 of chapter 400, are exempt from s. 408.810(10).
946 (15)(16) Nurse registries, as provided under part III of
947 chapter 400, are exempt from s. 408.810(6) and (10).
948 (16)(17) Companion services or homemaker services
949 providers, as provided under part III of chapter 400, are exempt
950 from s. 408.810(6)-(10).
951 (17)(18) Adult day care centers, as provided under part III
952 of chapter 429, are exempt from s. 408.810(10).
953 (18)(19) Adult family-care homes, as provided under part II
954 of chapter 429, are exempt from s. 408.810(7)-(10).
955 (18)(20) Homes for special services, as provided under part
956 V of chapter 400, are exempt from s. 408.810(7)-(10).
957 (20)(21) Transitional living facilities, as provided under
958 part V of chapter 400, are exempt from s. 408.810(10) s.
959 408.810(7)-(10).
960 (21)(22) Prescribed pediatric extended care centers, as
961 provided under part VI of chapter 400, are exempt from s.
962 408.810(10).
963 (22)(23) Home medical equipment providers, as provided
964 under part VII of chapter 400, are exempt from s. 408.810(10).
965 (23)(24) Intermediate care facilities for persons with
966 developmental disabilities, as provided under part VIII of
967 chapter 400, are exempt from s. 408.810(7).
968 (24)(25) Health care services pools, as provided under part
969 IX of chapter 400, are exempt from s. 408.810(6)-(10).
970 (25)(26) Health care clinics, as provided under part X of
971 chapter 400, are exempt from s. 408.810(6), (7), (10) ss.
972 408.809 and 408.810(1), (6), (7), and (10).
973 (26)(27) Clinical laboratories, as provided under part I of
974 chapter 483, are exempt from s. 408.810(5)-(10).
975 (27)(28) Multiphasic health testing centers, as provided
976 under part II of chapter 483, are exempt from s. 408.810(5)
977 (10).
978 (28)(29) Organ and tissue procurement agencies, as provided
979 under chapter 765, are exempt from s. 408.810(5)-(10).
980 Section 21. Section 408.821, Florida Statutes, is created
981 to read:
982 408.821 Emergency management planning; emergency
983 operations; inactive license.—
984 (1) A licensee required by authorizing statutes to have an
985 emergency operations plan must designate a safety liaison to
986 serve as the primary contact for emergency operations.
987 (2) An entity subject to this part may temporarily exceed
988 its licensed capacity to act as a receiving provider in
989 accordance with an approved emergency operations plan for up to
990 15 days. While in an overcapacity status, each provider must
991 furnish or arrange for appropriate care and services to all
992 clients. In addition, the agency may approve requests for
993 overcapacity in excess of 15 days, which approvals may be based
994 upon satisfactory justification and need as provided by the
995 receiving and sending providers.
996 (3)(a) An inactive license may be issued to a licensee
997 subject to this section when the provider is located in a
998 geographic area in which a state of emergency was declared by
999 the Governor if the provider:
1000 1. Suffered damage to its operation during the state of
1001 emergency.
1002 2. Is currently licensed.
1003 3. Does not have a provisional license.
1004 4. Will be temporarily unable to provide services but is
1005 reasonably expected to resume services within 12 months.
1006 (b) An inactive license may be issued for a period not to
1007 exceed 12 months but may be renewed by the agency for up to 12
1008 additional months upon demonstration to the agency of progress
1009 toward reopening. A request by a licensee for an inactive
1010 license or to extend the previously approved inactive period
1011 must be submitted in writing to the agency, accompanied by
1012 written justification for the inactive license, which states the
1013 beginning and ending dates of inactivity and includes a plan for
1014 the transfer of any clients to other providers and appropriate
1015 licensure fees. Upon agency approval, the licensee shall notify
1016 clients of any necessary discharge or transfer as required by
1017 authorizing statutes or applicable rules. The beginning of the
1018 inactive licensure period shall be the date the provider ceases
1019 operations. The end of the inactive period shall become the
1020 license expiration date, and all licensure fees must be current,
1021 must be paid in full, and may be prorated. Reactivation of an
1022 inactive license requires the prior approval by the agency of a
1023 renewal application, including payment of licensure fees and
1024 agency inspections indicating compliance with all requirements
1025 of this part and applicable rules and statutes.
1026 (4) The agency may adopt rules relating to emergency
1027 management planning, communications, and operations. Licensees
1028 providing residential or inpatient services must utilize an
1029 online database approved by the agency to report information to
1030 the agency regarding the provider’s emergency status, planning,
1031 or operations.
1032 Section 22. Section 408.831, Florida Statutes, is amended
1033 to read:
1034 408.831 Denial, suspension, or revocation of a license,
1035 registration, certificate, or application.—
1036 (1) In addition to any other remedies provided by law, the
1037 agency may deny each application or suspend or revoke each
1038 license, registration, or certificate of entities regulated or
1039 licensed by it:
1040 (a) If the applicant, licensee, or a licensee subject to
1041 this part which shares a common controlling interest with the
1042 applicant has failed to pay all outstanding fines, liens, or
1043 overpayments assessed by final order of the agency or final
1044 order of the Centers for Medicare and Medicaid Services, not
1045 subject to further appeal, unless a repayment plan is approved
1046 by the agency; or
1047 (b) For failure to comply with any repayment plan.
1048 (2) In reviewing any application requesting a change of
1049 ownership or change of the licensee, registrant, or
1050 certificateholder, the transferor shall, prior to agency
1051 approval of the change, repay or make arrangements to repay any
1052 amounts owed to the agency. Should the transferor fail to repay
1053 or make arrangements to repay the amounts owed to the agency,
1054 the issuance of a license, registration, or certificate to the
1055 transferee shall be delayed until repayment or until
1056 arrangements for repayment are made.
1057 (3) An entity subject to this section may exceed its
1058 licensed capacity to act as a receiving facility in accordance
1059 with an emergency operations plan for clients of evacuating
1060 providers from a geographic area where an evacuation order has
1061 been issued by a local authority having jurisdiction. While in
1062 an overcapacity status, each provider must furnish or arrange
1063 for appropriate care and services to all clients. In addition,
1064 the agency may approve requests for overcapacity beyond 15 days,
1065 which approvals may be based upon satisfactory justification and
1066 need as provided by the receiving and sending facilities.
1067 (4)(a) An inactive license may be issued to a licensee
1068 subject to this section when the provider is located in a
1069 geographic area where a state of emergency was declared by the
1070 Governor if the provider:
1071 1. Suffered damage to its operation during that state of
1072 emergency.
1073 2. Is currently licensed.
1074 3. Does not have a provisional license.
1075 4. Will be temporarily unable to provide services but is
1076 reasonably expected to resume services within 12 months.
1077 (b) An inactive license may be issued for a period not to
1078 exceed 12 months but may be renewed by the agency for up to 12
1079 additional months upon demonstration to the agency of progress
1080 toward reopening. A request by a licensee for an inactive
1081 license or to extend the previously approved inactive period
1082 must be submitted in writing to the agency, accompanied by
1083 written justification for the inactive license, which states the
1084 beginning and ending dates of inactivity and includes a plan for
1085 the transfer of any clients to other providers and appropriate
1086 licensure fees. Upon agency approval, the licensee shall notify
1087 clients of any necessary discharge or transfer as required by
1088 authorizing statutes or applicable rules. The beginning of the
1089 inactive licensure period shall be the date the provider ceases
1090 operations. The end of the inactive period shall become the
1091 licensee expiration date, and all licensure fees must be
1092 current, paid in full, and may be prorated. Reactivation of an
1093 inactive license requires the prior approval by the agency of a
1094 renewal application, including payment of licensure fees and
1095 agency inspections indicating compliance with all requirements
1096 of this part and applicable rules and statutes.
1097 (3)(5) This section provides standards of enforcement
1098 applicable to all entities licensed or regulated by the Agency
1099 for Health Care Administration. This section controls over any
1100 conflicting provisions of chapters 39, 383, 390, 391, 394, 395,
1101 400, 408, 429, 468, 483, and 765 or rules adopted pursuant to
1102 those chapters.
1103 Section 23. Paragraph (e) of subsection (4) of section
1104 409.221, Florida Statutes, is amended to read:
1105 409.221 Consumer-directed care program.—
1106 (4) CONSUMER-DIRECTED CARE.—
1107 (e) Services.—Consumers shall use the budget allowance only
1108 to pay for home and community-based services that meet the
1109 consumer’s long-term care needs and are a cost-efficient use of
1110 funds. Such services may include, but are not limited to, the
1111 following:
1112 1. Personal care.
1113 2. Homemaking and chores, including housework, meals,
1114 shopping, and transportation.
1115 3. Home modifications and assistive devices which may
1116 increase the consumer’s independence or make it possible to
1117 avoid institutional placement.
1118 4. Assistance in taking self-administered medication.
1119 5. Day care and respite care services, including those
1120 provided by nursing home facilities pursuant to s. 400.141(1)(f)
1121 s. 400.141(6) or by adult day care facilities licensed pursuant
1122 to s. 429.907.
1123 6. Personal care and support services provided in an
1124 assisted living facility.
1125 Section 24. Subsection (5) of section 409.901, Florida
1126 Statutes, is amended to read:
1127 409.901 Definitions; ss. 409.901-409.920.—As used in ss.
1128 409.901-409.920, except as otherwise specifically provided, the
1129 term:
1130 (5) “Change of ownership” means:
1131 (a) An event in which the provider ownership changes to a
1132 different individual legal entity as evidenced by a change in
1133 federal employer identification number or taxpayer
1134 identification number; or
1135 (b) An event in which 51 45 percent or more of the
1136 ownership, voting shares, membership, or controlling interest of
1137 a provider is in any manner transferred or otherwise assigned.
1138 This paragraph does not apply to a licensee that is publicly
1139 traded on a recognized stock exchange; or
1140 (c) When the provider is licensed or registered by the
1141 agency, an event considered a change of ownership for licensure
1142 as defined in s. 408.803 in a corporation whose shares are not
1143 publicly traded on a recognized stock exchange is transferred or
1144 assigned, including the final transfer or assignment of multiple
1145 transfers or assignments over a 2-year period that cumulatively
1146 total 45 percent or more.
1147
1148 A change solely in the management company or board of directors
1149 is not a change of ownership.
1150 Section 25. Section 429.071, Florida Statutes, is repealed.
1151 Section 26. Paragraph (e) of subsection (1) and subsections
1152 (2) and (3) of section 429.08, Florida Statutes, are amended to
1153 read:
1154 429.08 Unlicensed facilities; referral of person for
1155 residency to unlicensed facility; penalties; verification of
1156 licensure status.—
1157 (1)
1158 (e) The agency shall publish provide to the department’s
1159 elder information and referral providers a list, by county, of
1160 licensed assisted living facilities, to assist persons who are
1161 considering an assisted living facility placement in locating a
1162 licensed facility. This information may be provided
1163 electronically or through the agency’s Internet site.
1164 (2) Each field office of the Agency for Health Care
1165 Administration shall establish a local coordinating workgroup
1166 which includes representatives of local law enforcement
1167 agencies, state attorneys, the Medicaid Fraud Control Unit of
1168 the Department of Legal Affairs, local fire authorities, the
1169 Department of Children and Family Services, the district long
1170 term care ombudsman council, and the district human rights
1171 advocacy committee to assist in identifying the operation of
1172 unlicensed facilities and to develop and implement a plan to
1173 ensure effective enforcement of state laws relating to such
1174 facilities. The workgroup shall report its findings, actions,
1175 and recommendations semiannually to the Director of Health
1176 Quality Assurance of the agency.
1177 (2)(3) It is unlawful to knowingly refer a person for
1178 residency to an unlicensed assisted living facility; to an
1179 assisted living facility the license of which is under denial or
1180 has been suspended or revoked; or to an assisted living facility
1181 that has a moratorium pursuant to part II of chapter 408. Any
1182 person who violates this subsection commits a noncriminal
1183 violation, punishable by a fine not exceeding $500 as provided
1184 in s. 775.083.
1185 (a) Any health care practitioner, as defined in s. 456.001,
1186 who is aware of the operation of an unlicensed facility shall
1187 report that facility to the agency. Failure to report a facility
1188 that the practitioner knows or has reasonable cause to suspect
1189 is unlicensed shall be reported to the practitioner’s licensing
1190 board.
1191 (b) Any provider as defined in s. 408.803 hospital or
1192 community mental health center licensed under chapter 395 or
1193 chapter 394 which knowingly discharges a patient or client to an
1194 unlicensed facility is subject to sanction by the agency.
1195 (c) Any employee of the agency or department, or the
1196 Department of Children and Family Services, who knowingly refers
1197 a person for residency to an unlicensed facility; to a facility
1198 the license of which is under denial or has been suspended or
1199 revoked; or to a facility that has a moratorium pursuant to part
1200 II of chapter 408 is subject to disciplinary action by the
1201 agency or department, or the Department of Children and Family
1202 Services.
1203 (d) The employer of any person who is under contract with
1204 the agency or department, or the Department of Children and
1205 Family Services, and who knowingly refers a person for residency
1206 to an unlicensed facility; to a facility the license of which is
1207 under denial or has been suspended or revoked; or to a facility
1208 that has a moratorium pursuant to part II of chapter 408 shall
1209 be fined and required to prepare a corrective action plan
1210 designed to prevent such referrals.
1211 (e) The agency shall provide the department and the
1212 Department of Children and Family Services with a list of
1213 licensed facilities within each county and shall update the list
1214 at least quarterly.
1215 (f) At least annually, the agency shall notify, in
1216 appropriate trade publications, physicians licensed under
1217 chapter 458 or chapter 459, hospitals licensed under chapter
1218 395, nursing home facilities licensed under part II of chapter
1219 400, and employees of the agency or the department, or the
1220 Department of Children and Family Services, who are responsible
1221 for referring persons for residency, that it is unlawful to
1222 knowingly refer a person for residency to an unlicensed assisted
1223 living facility and shall notify them of the penalty for
1224 violating such prohibition. The department and the Department of
1225 Children and Family Services shall, in turn, notify service
1226 providers under contract to the respective departments who have
1227 responsibility for resident referrals to facilities. Further,
1228 the notice must direct each noticed facility and individual to
1229 contact the appropriate agency office in order to verify the
1230 licensure status of any facility prior to referring any person
1231 for residency. Each notice must include the name, telephone
1232 number, and mailing address of the appropriate office to
1233 contact.
1234 Section 27. Paragraph (e) of subsection (1) of section
1235 429.14, Florida Statutes, is amended to read:
1236 429.14 Administrative penalties.—
1237 (1) In addition to the requirements of part II of chapter
1238 408, the agency may deny, revoke, and suspend any license issued
1239 under this part and impose an administrative fine in the manner
1240 provided in chapter 120 against a licensee of an assisted living
1241 facility for a violation of any provision of this part, part II
1242 of chapter 408, or applicable rules, or for any of the following
1243 actions by a licensee of an assisted living facility, for the
1244 actions of any person subject to level 2 background screening
1245 under s. 408.809, or for the actions of any facility employee:
1246 (e) A citation of any of the following deficiencies as
1247 specified defined in s. 429.19:
1248 1. One or more cited class I deficiencies.
1249 2. Three or more cited class II deficiencies.
1250 3. Five or more cited class III deficiencies that have been
1251 cited on a single survey and have not been corrected within the
1252 times specified.
1253 Section 28. Section 429.19, Florida Statutes, is amended to
1254 read:
1255 429.19 Violations; imposition of administrative fines;
1256 grounds.—
1257 (1) In addition to the requirements of part II of chapter
1258 408, the agency shall impose an administrative fine in the
1259 manner provided in chapter 120 for the violation of any
1260 provision of this part, part II of chapter 408, and applicable
1261 rules by an assisted living facility, for the actions of any
1262 person subject to level 2 background screening under s. 408.809,
1263 for the actions of any facility employee, or for an intentional
1264 or negligent act seriously affecting the health, safety, or
1265 welfare of a resident of the facility.
1266 (2) Each violation of this part and adopted rules shall be
1267 classified according to the nature of the violation and the
1268 gravity of its probable effect on facility residents. The agency
1269 shall indicate the classification on the written notice of the
1270 violation as follows:
1271 (a) Class “I” violations are defined in s. 408.813 those
1272 conditions or occurrences related to the operation and
1273 maintenance of a facility or to the personal care of residents
1274 which the agency determines present an imminent danger to the
1275 residents or guests of the facility or a substantial probability
1276 that death or serious physical or emotional harm would result
1277 therefrom. The condition or practice constituting a class I
1278 violation shall be abated or eliminated within 24 hours, unless
1279 a fixed period, as determined by the agency, is required for
1280 correction. The agency shall impose an administrative fine for a
1281 cited class I violation in an amount not less than $5,000 and
1282 not exceeding $10,000 for each violation. A fine may be levied
1283 notwithstanding the correction of the violation.
1284 (b) Class “II” violations are defined in s. 408.813 those
1285 conditions or occurrences related to the operation and
1286 maintenance of a facility or to the personal care of residents
1287 which the agency determines directly threaten the physical or
1288 emotional health, safety, or security of the facility residents,
1289 other than class I violations. The agency shall impose an
1290 administrative fine for a cited class II violation in an amount
1291 not less than $1,000 and not exceeding $5,000 for each
1292 violation. A fine shall be levied notwithstanding the correction
1293 of the violation.
1294 (c) Class “III” violations are defined in s. 408.813 those
1295 conditions or occurrences related to the operation and
1296 maintenance of a facility or to the personal care of residents
1297 which the agency determines indirectly or potentially threaten
1298 the physical or emotional health, safety, or security of
1299 facility residents, other than class I or class II violations.
1300 The agency shall impose an administrative fine for a cited class
1301 III violation in an amount not less than $500 and not exceeding
1302 $1,000 for each violation. A citation for a class III violation
1303 must specify the time within which the violation is required to
1304 be corrected. If a class III violation is corrected within the
1305 time specified, no fine may be imposed, unless it is a repeated
1306 offense.
1307 (d) Class “IV” violations are defined in s. 408.813 those
1308 conditions or occurrences related to the operation and
1309 maintenance of a building or to required reports, forms, or
1310 documents that do not have the potential of negatively affecting
1311 residents. These violations are of a type that the agency
1312 determines do not threaten the health, safety, or security of
1313 residents of the facility. The agency shall impose an
1314 administrative fine for a cited class IV violation in an amount
1315 not less than $100 and not exceeding $200 for each violation. A
1316 citation for a class IV violation must specify the time within
1317 which the violation is required to be corrected. If a class IV
1318 violation is corrected within the time specified, no fine shall
1319 be imposed. Any class IV violation that is corrected during the
1320 time an agency survey is being conducted will be identified as
1321 an agency finding and not as a violation.
1322 (3) For purposes of this section, in determining if a
1323 penalty is to be imposed and in fixing the amount of the fine,
1324 the agency shall consider the following factors:
1325 (a) The gravity of the violation, including the probability
1326 that death or serious physical or emotional harm to a resident
1327 will result or has resulted, the severity of the action or
1328 potential harm, and the extent to which the provisions of the
1329 applicable laws or rules were violated.
1330 (b) Actions taken by the owner or administrator to correct
1331 violations.
1332 (c) Any previous violations.
1333 (d) The financial benefit to the facility of committing or
1334 continuing the violation.
1335 (e) The licensed capacity of the facility.
1336 (4) Each day of continuing violation after the date fixed
1337 for termination of the violation, as ordered by the agency,
1338 constitutes an additional, separate, and distinct violation.
1339 (5) During an inspection, any action taken to correct a
1340 violation shall be documented in writing by the owner or
1341 administrator of the facility and verified through followup
1342 visits by agency personnel. The agency may impose a fine and, in
1343 the case of an owner-operated facility, revoke or deny a
1344 facility’s license when a facility administrator fraudulently
1345 misrepresents action taken to correct a violation.
1346 (6) Any facility whose owner fails to apply for a change
1347 of-ownership license in accordance with part II of chapter 408
1348 and operates the facility under the new ownership is subject to
1349 a fine of $5,000.
1350 (7) In addition to any administrative fines imposed, the
1351 agency may assess a survey fee, equal to the lesser of one half
1352 of the facility’s biennial license and bed fee or $500, to cover
1353 the cost of conducting initial complaint investigations that
1354 result in the finding of a violation that was the subject of the
1355 complaint or monitoring visits conducted under s. 429.28(3)(c)
1356 to verify the correction of the violations.
1357 (8) The agency, as an alternative to or in conjunction with
1358 an administrative action against a facility for violations of
1359 this part and adopted rules, shall make a reasonable attempt to
1360 discuss each violation and recommended corrective action with
1361 the owner or administrator of the facility, prior to written
1362 notification. The agency, instead of fixing a period within
1363 which the facility shall enter into compliance with standards,
1364 may request a plan of corrective action from the facility which
1365 demonstrates a good faith effort to remedy each violation by a
1366 specific date, subject to the approval of the agency.
1367 (9) The agency shall develop and disseminate an annual list
1368 of all facilities sanctioned or fined $5,000 or more for
1369 violations of state standards, the number and class of
1370 violations involved, the penalties imposed, and the current
1371 status of cases. The list shall be disseminated, at no charge,
1372 to the Department of Elderly Affairs, the Department of Health,
1373 the Department of Children and Family Services, the Agency for
1374 Persons with Disabilities, the area agencies on aging, the
1375 Florida Statewide Advocacy Council, and the state and local
1376 ombudsman councils. The Department of Children and Family
1377 Services shall disseminate the list to service providers under
1378 contract to the department who are responsible for referring
1379 persons to a facility for residency. The agency may charge a fee
1380 commensurate with the cost of printing and postage to other
1381 interested parties requesting a copy of this list. This
1382 information may be provided electronically or through the
1383 agency’s Internet site.
1384 Section 29. Subsections (2) and (6) of section 429.23,
1385 Florida Statutes, are amended to read:
1386 429.23 Internal risk management and quality assurance
1387 program; adverse incidents and reporting requirements.—
1388 (2) Every facility licensed under this part is required to
1389 maintain adverse incident reports. For purposes of this section,
1390 the term, “adverse incident” means:
1391 (a) An event over which facility personnel could exercise
1392 control rather than as a result of the resident’s condition and
1393 results in:
1394 1. Death;
1395 2. Brain or spinal damage;
1396 3. Permanent disfigurement;
1397 4. Fracture or dislocation of bones or joints;
1398 5. Any condition that required medical attention to which
1399 the resident has not given his or her consent, including failure
1400 to honor advanced directives;
1401 6. Any condition that requires the transfer of the resident
1402 from the facility to a unit providing more acute care due to the
1403 incident rather than the resident’s condition before the
1404 incident; or.
1405 7. An event that is reported to law enforcement or its
1406 personnel for investigation; or
1407 (b) Abuse, neglect, or exploitation as defined in s.
1408 415.102;
1409 (c) Events reported to law enforcement; or
1410 (b)(d) Resident elopement, if the elopement places the
1411 resident at risk of harm or injury.
1412 (6) Abuse, neglect, or exploitation must be reported to the
1413 Department of Children and Family Services as required under
1414 chapter 415 The agency shall annually submit to the Legislature
1415 a report on assisted living facility adverse incident reports.
1416 The report must include the following information arranged by
1417 county:
1418 (a) A total number of adverse incidents;
1419 (b) A listing, by category, of the type of adverse
1420 incidents occurring within each category and the type of staff
1421 involved;
1422 (c) A listing, by category, of the types of injuries, if
1423 any, and the number of injuries occurring within each category;
1424 (d) Types of liability claims filed based on an adverse
1425 incident report or reportable injury; and
1426 (e) Disciplinary action taken against staff, categorized by
1427 the type of staff involved.
1428 Section 30. Subsection (9) of section 429.26, Florida
1429 Statutes, is repealed.
1430 Section 31. Subsection (3) of section 430.80, Florida
1431 Statutes, is amended to read:
1432 430.80 Implementation of a teaching nursing home pilot
1433 project.—
1434 (3) To be designated as a teaching nursing home, a nursing
1435 home licensee must, at a minimum:
1436 (a) Provide a comprehensive program of integrated senior
1437 services that include institutional services and community-based
1438 services;
1439 (b) Participate in a nationally recognized accreditation
1440 program and hold a valid accreditation, such as the
1441 accreditation awarded by the Joint Commission on Accreditation
1442 of Healthcare Organizations;
1443 (c) Have been in business in this state for a minimum of 10
1444 consecutive years;
1445 (d) Demonstrate an active program in multidisciplinary
1446 education and research that relates to gerontology;
1447 (e) Have a formalized contractual relationship with at
1448 least one accredited health profession education program located
1449 in this state;
1450 (f) Have a formalized contractual relationship with an
1451 accredited hospital that is designated by law as a teaching
1452 hospital; and
1453 (g) Have senior staff members who hold formal faculty
1454 appointments at universities, which must include at least one
1455 accredited health profession education program.
1456 (h) Maintain insurance coverage pursuant to s.
1457 400.141(1)(s) s. 400.141(20) or proof of financial
1458 responsibility in a minimum amount of $750,000. Such proof of
1459 financial responsibility may include:
1460 1. Maintaining an escrow account consisting of cash or
1461 assets eligible for deposit in accordance with s. 625.52; or
1462 2. Obtaining and maintaining pursuant to chapter 675 an
1463 unexpired, irrevocable, nontransferable and nonassignable letter
1464 of credit issued by any bank or savings association organized
1465 and existing under the laws of this state or any bank or savings
1466 association organized under the laws of the United States that
1467 has its principal place of business in this state or has a
1468 branch office which is authorized to receive deposits in this
1469 state. The letter of credit shall be used to satisfy the
1470 obligation of the facility to the claimant upon presentment of a
1471 final judgment indicating liability and awarding damages to be
1472 paid by the facility or upon presentment of a settlement
1473 agreement signed by all parties to the agreement when such final
1474 judgment or settlement is a result of a liability claim against
1475 the facility.
1476 Section 32. Subsection (5) of section 435.04, Florida
1477 Statutes, is amended to read:
1478 435.04 Level 2 screening standards.—
1479 (5) Under penalty of perjury, all employees in such
1480 positions of trust or responsibility shall attest to meeting the
1481 requirements for qualifying for employment and agreeing to
1482 inform the employer immediately if convicted of any of the
1483 disqualifying offenses while employed by the employer. Each
1484 employer of employees in such positions of trust or
1485 responsibilities which is licensed or registered by a state
1486 agency shall submit to the licensing agency annually or at the
1487 time of license renewal, under penalty of perjury, an affidavit
1488 of compliance with the provisions of this section.
1489 Section 33. Subsection (3) of section 435.05, Florida
1490 Statutes, is amended to read:
1491 435.05 Requirements for covered employees.—Except as
1492 otherwise provided by law, the following requirements shall
1493 apply to covered employees:
1494 (3) Each employer required to conduct level 2 background
1495 screening must sign an affidavit annually or at the time of
1496 license renewal, under penalty of perjury, stating that all
1497 covered employees have been screened or are newly hired and are
1498 awaiting the results of the required screening checks.
1499 Section 34. Subsection (2) of section 483.031, Florida
1500 Statutes, is amended to read:
1501 483.031 Application of part; exemptions.—This part applies
1502 to all clinical laboratories within this state, except:
1503 (2) A clinical laboratory that performs only waived tests
1504 and has received a certificate of exemption from the agency
1505 under s. 483.106.
1506 Section 35. Subsection (10) of section 483.041, Florida
1507 Statutes, is amended to read:
1508 483.041 Definitions.—As used in this part, the term:
1509 (10) “Waived test” means a test that the federal Centers
1510 for Medicare and Medicaid Services Health Care Financing
1511 Administration has determined qualifies for a certificate of
1512 waiver under the federal Clinical Laboratory Improvement
1513 Amendments of 1988, and the federal rules adopted thereunder.
1514 Section 36. Section 483.106, Florida Statutes, is repealed.
1515 Section 37. Subsection (3) of section 483.172, Florida
1516 Statutes, is amended to read:
1517 483.172 License fees.—
1518 (3) The agency shall assess a biennial fee of $100 for a
1519 certificate of exemption and a $100 biennial license fee under
1520 this section for facilities surveyed by an approved accrediting
1521 organization.
1522 Section 38. Subsection (13) of section 651.118, Florida
1523 Statutes, is amended to read:
1524 651.118 Agency for Health Care Administration; certificates
1525 of need; sheltered beds; community beds.—
1526 (13) Residents, as defined in this chapter, are not
1527 considered new admissions for the purpose of s. 400.141
1528 (1)(o)1.d. s. 400.141(15)(d).
1529 Section 39. This act shall take effect upon becoming a law.
1530
1531 ================= T I T L E A M E N D M E N T ================
1532 And the title is amended as follows:
1533 Delete everything before the enacting clause
1534 and insert:
1535 A bill to be entitled
1536 An act relating to the Agency for Health Care
1537 Administration; repealing s. 395.0199, F.S., relating
1538 to private utilization review of health care services;
1539 amending ss. 395.405 and 400.0712, F.S.; conforming
1540 cross-references; repealing s. 400.118(2), F.S.;
1541 removing provisions requiring quality-of-care monitors
1542 for nursing facilities in agency district offices;
1543 amending s. 400.141, F.S.; deleting a requirement that
1544 licensed nursing home facilities provide the agency
1545 with a monthly report on the number of vacant beds in
1546 the facility; amending s. 400.147, F.S.; revising the
1547 definition of the term “adverse incident” for
1548 reporting purposes; requiring abuse, neglect, and
1549 exploitation to be reported to the agency and the
1550 Department of Children and Family Services; deleting a
1551 requirement that the agency submit an annual report on
1552 nursing home adverse incidents to the Legislature;
1553 amending s. 400.162, F.S.; revising requirements for
1554 policies and procedures regarding the safekeeping of a
1555 resident’s personal effects and property; amending s.
1556 400.195, F.S.; conforming a cross-reference; amending
1557 s. 400.23, F.S.; deleting the requirement of the
1558 agency to adopt rules regarding the eating assistance
1559 provided to residents; amending s. 400.506, F.S.;
1560 providing an exception for the agency to deny,
1561 suspend, or revoke the license of a nurse registry;
1562 amending s. 400.9935, F.S.; revising accreditation
1563 requirements for clinics providing magnetic resonance
1564 imaging services; amending s. 400.995, F.S.; revising
1565 agency responsibilities with respect to agency
1566 administrative penalties; amending s. 408.803, F.S.;
1567 revising definitions applicable to part II of ch. 408,
1568 F.S., the “Health Care Licensing Procedures Act”;
1569 amending s. 408.806, F.S.; revising contents of and
1570 procedures relating to health care provider
1571 applications for licensure; providing an exception
1572 from certain licensure inspections for adult family
1573 care homes; authorizing the agency to provide
1574 electronic access to certain information and
1575 documents; amending s. 408.808, F.S.; providing for a
1576 provisional license to be issued to applicants
1577 applying for a change of ownership; providing a time
1578 limit on provisional licenses; amending s. 408.809,
1579 F.S.; revising provisions relating to background
1580 screening of specified employees; requiring health
1581 care providers to submit to the agency an affidavit of
1582 compliance with background screening requirements at
1583 the time of license renewal; deleting a provision to
1584 conform to changes made by the act; amending s.
1585 408.810, F.S.; revising provisions relating to
1586 information required for licensure; amending s.
1587 408.811, F.S.; providing for certain inspections to be
1588 accepted in lieu of complete licensure inspections;
1589 granting agency access to records requested during an
1590 offsite review; providing timeframes for correction of
1591 certain deficiencies and submission of plans to
1592 correct the deficiencies; amending s. 408.813, F.S.;
1593 providing classifications of violations of part II of
1594 ch. 408, F.S.; providing for fines; amending s.
1595 408.820, F.S.; revising applicability of certain
1596 exemptions from specified requirements of part II of
1597 ch. 408, F.S.; creating s. 408.821, F.S.; requiring
1598 entities regulated or licensed by the agency to
1599 designate a liaison officer for emergency operations;
1600 authorizing entities regulated or licensed by the
1601 agency to temporarily exceed their licensed capacity
1602 to act as receiving providers under specified
1603 circumstances; providing requirements that apply while
1604 such entities are in an overcapacity status; providing
1605 for issuance of an inactive license to such licensees
1606 under specified conditions; providing requirements and
1607 procedures with respect to the issuance and
1608 reactivation of an inactive license; authorizing the
1609 agency to adopt rules; amending s. 408.831, F.S.;
1610 deleting provisions relating to the authorization for
1611 entities regulated or licensed by the agency to exceed
1612 their licensed capacity to act as receiving facilities
1613 and issuance and reactivation of inactive licenses;
1614 amending s. 409.221, F.S.; conforming a cross
1615 reference; amending s. 409.901, F.S.; redefining the
1616 term “change of ownership” as it relates to Medicaid
1617 providers; repealing s. 429.071, F.S., relating to the
1618 intergenerational respite care assisted living
1619 facility pilot program; amending s. 429.08, F.S.;
1620 authorizing the agency to provide information
1621 regarding licensed assisted living facilities on its
1622 Internet website; abolishing local coordinating
1623 workgroups established by agency field offices;
1624 amending s. 429.14, F.S.; conforming a reference;
1625 amending s. 429.19, F.S.; revising agency procedures
1626 for imposition of fines for violations of part I of
1627 ch. 429, F.S., the “Assisted Living Facilities Act”;
1628 amending s. 429.23, F.S.; redefining the term “adverse
1629 incident” for reporting purposes; requiring abuse,
1630 neglect, and exploitation to be reported to the agency
1631 and the Department of Children and Family Services;
1632 deleting a requirement that the agency submit an
1633 annual report on assisted living facility adverse
1634 incidents to the Legislature; repealing s. 429.26(9),
1635 F.S., relating to the removal of the requirement for a
1636 resident of an assisted living facility to undergo
1637 examinations and evaluations under certain
1638 circumstances; amending s. 430.80, F.S.; conforming a
1639 cross-reference; amending ss. 435.04 and 435.05, F.S.;
1640 requiring employers of certain employees to submit an
1641 affidavit of compliance with level 2 screening
1642 requirements at the time of license renewal; amending
1643 s. 483.031, F.S.; revising a provision relating to the
1644 exemption of certain clinical laboratories, to conform
1645 to changes made by the act; amending s. 483.041, F.S.;
1646 redefining the term “waived test” as it is used in
1647 part I of ch. 483, F.S., the “Florida Clinical
1648 Laboratory Law”; repealing s. 483.106, F.S., relating
1649 to applications for certificates of exemption by
1650 clinical laboratories that perform certain tests;
1651 amending ss. 483.172 and 651.118, F.S.; conforming
1652 provisions and a cross-reference; providing an
1653 effective date.