CS/CS/HB 1037

1	A bill to be entitled
2	An act relating to continuing care retirement communities;
3	providing for the provision of continuing care at-home;
4	amending s. 651.011, F.S.; revising definitions; defining
5	"continuing care at-home," "nursing care," "personal
6	services," and "shelter"; amending s. 651.012, F.S.;
7	conforming a cross-reference; amending s. 651.013, F.S.;
8	conforming provisions to changes made by the act; amending
9	s. 651.021, F.S., relating to the requirement for
10	certificates of authority; requiring that a person in the
11	business of issuing continuing care at-home contracts
12	obtain a certificate of authority from the Office of
13	Insurance Regulation; requiring written approval from the
14	Office of Insurance Regulation for a 20 percent or more
15	expansion in the number of continuing care at-home
16	contracts; providing that an actuarial study may be
17	substituted for a feasibility study in specified
18	circumstances; amending s. 651.022, F.S., relating to
19	provisional certificates of authority; conforming
20	provisions to changes made by the act; amending s.
21	651.023, F.S., relating to an application for a
22	certificate of authority; specifying the content of the
23	feasibility study that is included in the application for
24	a certificate; requiring the same minimum reservation
25	requirements for continuing care at-home contracts as
26	continuing care contracts; requiring that a certain amount
27	of the entrance fee collected for contracts resulting from
28	an expansion be placed in an escrow account or on deposit
29	with the department; amending ss. 651.033, 651.035, and
30	651.055, F.S.; requiring a facility to provide proof of
31	compliance with a residency contract; conforming
32	provisions to changes made by the act; providing
33	application relating to the entitlement of a prospective
34	resident, resident, or resident's estate to interest on a
35	deposit or entrance fee; creating s. 651.057, F.S.;
36	providing additional requirements for continuing care at-
37	home contracts; requiring that a provider who wishes to
38	offer continuing care at-home contracts submit certain
39	additional documents to the office; requiring that the
40	provider comply with certain requirements; limiting the
41	number of continuing care and continuing care at-home
42	contracts at a facility based on the types of units at the
43	facility; amending ss. 651.071, 651.091, 651.106, 651.114,
44	651.118, 651.121, and 651.125, F.S.; conforming provisions
45	to changes made by the act; providing an effective date.
46
47	Be It Enacted by the Legislature of the State of Florida:
48
49	Section 1.  Section 651.011, Florida Statutes, is amended
50	to read:
51	651.011  Definitions.-As used in For the purposes of this
52	chapter, the term:
53	(1)  "Advertising" means the dissemination of written,
54	visual, or electronic information by a provider, or any person
55	affiliated with or controlled by a provider, to potential
56	residents or their representatives for the purpose of inducing
57	such persons to subscribe to or enter into a contract for
58	continuing care or continuing care at-home to reside in a
59	continuing care community that is subject to this chapter.
60	(2)  "Continuing care" or "care" means, pursuant to a
61	contract, furnishing shelter and nursing care or personal
62	services to a resident who resides in a facility as defined in
63	s. 429.02, whether such nursing care or personal services are
64	provided in the facility or in another setting designated in by
65	the contract for continuing care, by to an individual not
66	related by consanguinity or affinity to the resident provider
67	furnishing such care, upon payment of an entrance fee. Other
68	personal services provided must be designated in the continuing
69	care contract. Contracts to provide continuing care include
70	agreements to provide care for any duration, including contracts
71	that are terminable by either party.
72	(3)  "Continuing Care Advisory Council" or "advisory
73	council" means the council established in s. 651.121.
74	(4)  "Continuing care at-home" means, pursuant to a
75	contract other than a contract described in subsection (2),
76	furnishing to a resident who resides outside the facility the
77	right to future access to shelter and nursing care or personal
78	services, whether such services are provided in the facility or
79	in another setting designated in the contract, by an individual
80	not related by consanguinity or affinity to the resident, upon
81	payment of an entrance fee.
82	(5)(4)  "Entrance fee" means an initial or deferred payment
83	of a sum of money or property made as full or partial payment
84	for continuing care or continuing care at-home to assure the
85	resident a place in a facility. An accommodation fee, admission
86	fee, member fee, or other fee of similar form and application
87	are considered to be an entrance fee.
88	(6)(5)  "Facility" means a place where that provides
89	continuing care is furnished and may include one or more
90	physical plants on a primary or contiguous site or an
91	immediately accessible site. As used in this subsection, the
92	term "immediately accessible site" means a parcel of real
93	property separated by a reasonable distance from the facility as
94	measured along public thoroughfares, and the term "primary or
95	contiguous site" means the real property contemplated in the
96	feasibility study required by this chapter.
97	(7)(6)  "Generally accepted accounting principles" means
98	those accounting principles and practices adopted by the
99	Financial Accounting Standards Board and the American Institute
100	of Certified Public Accountants, including Statement of Position
101	90-8 with respect to any full year to which the statement
102	applies.
103	(8)(7)  "Insolvency" means the condition in which the
104	provider is unable to pay its obligations as they come due in
105	the normal course of business.
106	(9)(8)  "Licensed" means that the provider has obtained a
107	certificate of authority from the department.
108	(10)  "Nursing care" means those services or acts rendered
109	to a resident by an individual licensed or certified pursuant to
110	chapter 464.
111	(11)  "Personal services" has the same meaning as in s.
112	429.02.
113	(12)(9)  "Provider" means the owner or operator, whether a
114	natural person, partnership or other unincorporated association,
115	however organized, trust, or corporation, of an institution,
116	building, residence, or other place, whether operated for profit
117	or not, which owner or operator provides continuing care or
118	continuing care at-home for a fixed or variable fee, or for any
119	other remuneration of any type, whether fixed or variable, for
120	the period of care, payable in a lump sum or lump sum and
121	monthly maintenance charges or in installments. The term, but
122	does not apply to mean an entity that has existed and
123	continuously operated a facility located on at least 63 acres in
124	this state providing residential lodging to members and their
125	spouses for at least 66 years on or before July 1, 1989, and has
126	the residential capacity of 500 persons, is directly or
127	indirectly owned or operated by a nationally recognized
128	fraternal organization, is not open to the public, and accepts
129	only its members and their spouses as residents.
130	(13)(10)  "Records" means the permanent financial,
131	directory, and personnel information and data maintained by a
132	provider pursuant to this chapter.
133	(14)(11)  "Resident" means a purchaser of, a nominee of, or
134	a subscriber to a continuing care or continuing care at-home
135	contract agreement. Such contract agreement does not give the
136	resident a part ownership of the facility in which the resident
137	is to reside, unless expressly provided for in the contract
138	agreement.
139	(15)  "Shelter" means an independent living unit, room,
140	apartment, cottage, villa, personal care unit, nursing bed, or
141	other living area within a facility set aside for the exclusive
142	use of one or more identified residents.
143	Section 2.  Section 651.012, Florida Statutes, is amended
144	to read:
145	651.012  Exempted facility; written disclosure of
146	exemption.-Any facility exempted under ss. 632.637(1)(e) and
147	651.011(12)(9) must provide written disclosure of such exemption
148	to each person admitted to the facility after October 1, 1996.
149	This disclosure must be written using language likely to be
150	understood by the person and must briefly explain the exemption.
151	Section 3.  Section 651.013, Florida Statutes, is amended
152	to read:
153	651.013  Chapter exclusive; applicability of other laws.-
154	(1)  Except as herein provided, providers of continuing
155	care and continuing care at-home are shall be governed by the
156	provisions of this chapter and are shall be exempt from all
157	other provisions of the Florida Insurance Code.
158	(2)  In addition to other applicable provisions cited in
159	this chapter, the office has the authority granted under ss.
160	624.302 and 624.303, 624.308-624.312, 624.319(1)-(3), 624.320-
161	624.321, 624.324, and 624.34 of the Florida Insurance Code to
162	regulate providers of continuing care and continuing care at-
163	home.
164	Section 4.  Section 651.021, Florida Statutes, is amended
165	to read:
166	651.021  Certificate of authority required.-
167	(1)  No person may engage in the business of providing
168	continuing care, or issuing contracts for continuing care or
169	continuing care at-home, or constructing agreements or construct
170	a facility for the purpose of providing continuing care in this
171	state without a certificate of authority therefor obtained from
172	the office as provided in this chapter. This subsection does
173	shall not be construed to prohibit the preparation of a the
174	construction site or construction of a model residence unit for
175	marketing purposes, or both. The office may allow the purchase
176	of an existing building for the purpose of providing continuing
177	care if the office determines that the purchase is not being
178	made to circumvent for the purpose of circumventing the
179	prohibitions contained in this section.
180	(2)(a)  Written approval must be obtained from the office
181	before commencing commencement of construction or marketing for
182	an any expansion of a certificated facility equivalent to the
183	addition of at least 20 percent of existing units or 20 percent
184	or more in the number of continuing care at-home contracts,
185	written approval must be obtained from the office. This
186	provision does not apply to construction for which a certificate
187	of need from the Agency for Health Care Administration is
188	required.
189	(a)  For providers that offer both continuing care and
190	continuing care at-home, the 20 percent is based on the total of
191	both existing units and existing contracts for continuing care
192	at-home. For purposes of this subsection, an expansion includes
193	increases in the number of constructed units or continuing care
194	at-home contracts or a combination of both.
195	(b)  The application for such approval shall be on forms
196	adopted by the commission and provided by the office. The
197	application must shall include the feasibility study required by
198	s. 651.022(3) or s. 651.023(1)(b) and such other information as
199	required by s. 651.023. If the expansion is only for continuing
200	care at-home contracts, an actuarial study prepared by an
201	independent actuary in accordance with standards adopted by the
202	American Academy of Actuaries which presents the financial
203	impact of the expansion may be substituted for the feasibility
204	study.
205	(c)  In determining whether an expansion should be
206	approved, the office shall use utilize the criteria provided in
207	ss. 651.022(6) and 651.023(4)(2).
208	Section 5.  Paragraphs (d) and (g) of subsection (2) and
209	subsections (4) and (6) of section 651.022, Florida Statutes,
210	are amended to read:
211	651.022  Provisional certificate of authority;
212	application.-
213	(2)  The application for a provisional certificate of
214	authority shall be on a form prescribed by the commission and
215	shall contain the following information:
216	(d)  The contracts agreements for continuing care and
217	continuing care at-home to be entered into between the provider
218	and residents which meet the minimum requirements of s. 651.055
219	or s. 651.057 and which include a statement describing the
220	procedures required by law relating to the release of escrowed
221	entrance fees. Such statement may be furnished through an
222	addendum.
223	(g)  The forms of the continuing care residency contracts,
224	reservation contracts, escrow agreements, and wait list
225	contracts, if applicable, which are proposed to be used by the
226	provider in the furnishing of care. If The office shall approve
227	finds that the continuing care contracts and escrow agreements
228	that comply with ss. 651.023(1)(c), 651.033, and 651.055, and
229	651.057 it shall approve them. Thereafter, no other form of
230	contract or agreement may be used by the provider until it has
231	been submitted to the office and approved.
232	(4)  If an applicant has or proposes to have more than one
233	facility offering continuing care or continuing care at-home, a
234	separate provisional certificate of authority and a separate
235	certificate of authority must shall be obtained for each
236	facility.
237	(6)  Within 45 days after from the date an application is
238	deemed to be complete, as set forth in paragraph (5)(b), the
239	office shall complete its review and shall issue a provisional
240	certificate of authority to the applicant based upon its review
241	and a determination that the application meets all requirements
242	of law, and that the feasibility study was based on sufficient
243	data and reasonable assumptions, and that the applicant will be
244	able to provide continuing care or continuing care at-home as
245	proposed and meet all financial obligations related to its
246	operations, including the financial requirements of this chapter
247	to provide continuing care as proposed. If the application is
248	denied, the office shall notify the applicant in writing, citing
249	the specific failures to meet the provisions of this chapter.
250	Such denial entitles shall entitle the applicant to a hearing
251	pursuant to the provisions of chapter 120.
252	Section 6.  Section 651.023, Florida Statutes, is amended
253	to read:
254	651.023  Certificate of authority; application.-
255	(1)  After issuance of a provisional certificate of
256	authority, the office shall issue to the holder of such
257	provisional certificate of authority a certificate of authority
258	if; provided, however, that no certificate of authority shall be
259	issued until the holder of the such provisional certificate of
260	authority provides the office with the following information:
261	(a)  Any material change in status with respect to the
262	information required to be filed under s. 651.022(2) in the
263	application for the a provisional certificate of authority.
264	(b)  A feasibility study prepared by an independent
265	consultant which contains all of the information required by s.
266	651.022(3) and contains financial forecasts or projections
267	prepared in accordance with standards adopted promulgated by the
268	American Institute of Certified Public Accountants or financial
269	forecasts or projections prepared in accordance with standards
270	for feasibility studies or continuing care retirement
271	communities adopted promulgated by the Actuarial Standards
272	Board.
273	1.  The study must also contain an independent evaluation
274	and examination opinion, or a comparable opinion acceptable to
275	the office, by the consultant who prepared the study, of the
276	underlying assumptions used as a basis for the forecasts or
277	projections in the study and that the assumptions are reasonable
278	and proper and that the project as proposed is feasible.
279	2.  The study must shall take into account project costs,
280	actual marketing results to date and marketing projections,
281	resident fees and charges, competition, resident contract
282	provisions, and any other factors which affect the feasibility
283	of operating the facility.
284	3.  If the study is prepared by an independent certified
285	public accountant, it must contain an examination opinion for
286	the first 3 years of operations and financial projections having
287	a compilation opinion for the next 3 years. If the study is
288	prepared by an independent consulting actuary, it must contain
289	mortality and morbidity data and an actuary's signed opinion
290	that the project as proposed is feasible and that the study has
291	been prepared in accordance with standards adopted by the
292	American Academy of Actuaries.
293	(c)  Subject to the requirements of subsection (4) (2), a
294	provider may submit an application for a certificate of
295	authority and any required exhibits upon submission of proof
296	that the project has a minimum of 30 percent of the units
297	reserved for which the provider is charging an entrance fee.;
298	however, This does provision shall not apply to an application
299	for a certificate of authority for the acquisition of a facility
300	for which a certificate of authority was issued before prior to
301	October 1, 1983, to a provider who subsequently becomes a debtor
302	in a case under the United States Bankruptcy Code, 11 U.S.C. ss.
303	101 et seq., or to a provider for which the department has been
304	appointed receiver pursuant to the provisions of part II of
305	chapter 631.
306	(d)  Proof that commitments have been secured for both
307	construction financing and long-term financing or a documented
308	plan acceptable to the office has been adopted by the applicant
309	for long-term financing.
310	(e)  Proof that all conditions of the lender have been
311	satisfied to activate the commitment to disburse funds other
312	than the obtaining of the certificate of authority, the
313	completion of construction, or the closing of the purchase of
314	realty or buildings for the facility.
315	(f)  Proof that the aggregate amount of entrance fees
316	received by or pledged to the applicant, plus anticipated
317	proceeds from any long-term financing commitment, plus funds
318	from all other sources in the actual possession of the
319	applicant, equal at least not less than 100 percent of the
320	aggregate cost of constructing or purchasing, equipping, and
321	furnishing the facility plus 100 percent of the anticipated
322	startup losses of the facility.
323	(g)  Complete audited financial statements of the
324	applicant, prepared by an independent certified public
325	accountant in accordance with generally accepted accounting
326	principles, as of the date the applicant commenced business
327	operations or for the fiscal year that ended immediately
328	preceding the date of application, whichever is later, and
329	complete unaudited quarterly financial statements attested to by
330	the applicant after subsequent to the date of the last audit.
331	(h)  Proof that the applicant has complied with the escrow
332	requirements of subsection (5) (3) or subsection (7) (5) and
333	will be able to comply with s. 651.035.
334	(i)  Such other reasonable data, financial statements, and
335	pertinent information as the commission or office may require
336	with respect to the applicant or the facility, to determine the
337	financial status of the facility and the management capabilities
338	of its managers and owners.
339	(2)(j)  Within 30 days after of the receipt of the
340	information required under subsection (1) paragraphs (a)-(h),
341	the office shall examine such information and shall notify the
342	provider in writing, specifically requesting any additional
343	information the office is permitted by law to require. Within 15
344	days after receipt of all of the requested additional
345	information, the office shall notify the provider in writing
346	that all of the requested information has been received and the
347	application is deemed to be complete as of the date of the
348	notice. Failure to so notify the applicant in writing within the
349	15-day period constitutes shall constitute acknowledgment by the
350	office that it has received all requested additional
351	information, and the application shall be deemed to be complete
352	for purposes of review on upon the date of the filing of all of
353	the required additional information.
354	(3)(k)  Within 45 days after an application is deemed
355	complete as set forth in subsection (2) paragraph (j), and upon
356	completion of the remaining requirements of this section, the
357	office shall complete its review and shall issue, or deny a
358	certificate of authority, to the holder of a provisional
359	certificate of authority a certificate of authority. If a
360	certificate of authority is denied, the office must shall notify
361	the holder of the provisional certificate of authority in
362	writing, citing the specific failures to satisfy the provisions
363	of this chapter. If denied, the holder of the provisional
364	certificate is of authority shall be entitled to an
365	administrative hearing pursuant to chapter 120.
366	(4)(2)(a)  The office shall issue a certificate of
367	authority upon determining its determination that the applicant
368	meets all requirements of law and has submitted all of the
369	information required by this section, that all escrow
370	requirements have been satisfied, and that the fees prescribed
371	in s. 651.015(2) have been paid.
372	(a)  Notwithstanding satisfaction of the 30-percent minimum
373	reservation requirement of paragraph (1)(c), no certificate of
374	authority shall be issued until the project has a minimum of 50
375	percent of the units reserved for which the provider is charging
376	an entrance fee, and proof thereof is provided to the office. If
377	a provider offering continuing care at-home is applying for a
378	certificate of authority or approval of an expansion pursuant to
379	s. 651.021(2), the same minimum reservation requirements must be
380	met for the continuing care and continuing care at-home
381	contracts, independently of each other.
382	(b)  In order for a unit to be considered reserved under
383	this section, the provider must collect a minimum deposit of 10
384	percent of the then-current entrance fee for that unit, and must
385	assess a forfeiture penalty of 2 percent of the entrance fee due
386	to termination of the reservation contract after 30 days for any
387	reason other than the death or serious illness of the resident,
388	the failure of the provider to meet its obligations under the
389	reservation contract, or other circumstances beyond the control
390	of the resident that equitably entitle the resident to a refund
391	of the resident's deposit. The reservation contract must shall
392	state the cancellation policy and the terms of the continuing
393	care or continuing care at-home contract to be entered into.
394	(5)(3)  Up to No more than 25 percent of the moneys paid
395	for all or any part of an initial entrance fee may be included
396	or pledged for the construction or purchase of the facility, or
397	included or pledged as security for long-term financing. The
398	term "initial entrance fee" means the total entrance fee charged
399	by the facility to the first occupant of a unit.
400	(a)  A minimum of 75 percent of the moneys paid for all or
401	any part of an initial entrance fee collected for continuing
402	care or continuing care at-home shall be placed in an escrow
403	account or on deposit with the department as prescribed in s.
404	651.033.
405	(b)  For an expansion as provided in s. 651.021(2), a
406	minimum of 75 percent of the moneys paid for all or any part of
407	an initial entrance fee collected for continuing care and 50
408	percent of the moneys paid for all or any part of an initial fee
409	collected for continuing care at-home shall be placed in an
410	escrow account or on deposit with the department as prescribed
411	in s. 651.033.
412	(6)(4)  The provider is shall be entitled to secure release
413	of the moneys held in escrow within 7 days after receipt by the
414	office of an affidavit from the provider, along with appropriate
415	copies to verify, and notification to the escrow agent by
416	certified mail, that the following conditions have been
417	satisfied:
418	(a)  A certificate of occupancy has been issued.
419	(b)  Payment in full has been received for at least no less
420	than 70 percent of the total units of a phase or of the total of
421	the combined phases constructed. If a provider offering
422	continuing care at-home is applying for a release of escrowed
423	entrance fees, the same minimum requirement must be met for the
424	continuing care and continuing care at-home contracts,
425	independently of each other.
426	(c)  The consultant who prepared the feasibility study
427	required by this section or a substitute approved by the office
428	certifies within 12 months before the date of filing for office
429	approval that there has been no material adverse change in
430	status with regard to the feasibility study, with such statement
431	dated not more than 12 months from the date of filing for office
432	approval. If a material adverse change exists should exist at
433	the time of submission, then sufficient information acceptable
434	to the office and the feasibility consultant must shall be
435	submitted which remedies the adverse condition.
436	(d)  Proof that commitments have been secured or a
437	documented plan adopted by the applicant has been approved by
438	the office for long-term financing.
439	(e)  Proof that the provider has sufficient funds to meet
440	the requirements of s. 651.035, which may include funds
441	deposited in the initial entrance fee account.
442	(f)  Proof as to the intended application of the proceeds
443	upon release and proof that the entrance fees when released will
444	be applied as represented to the office.
445
446	Notwithstanding any provision of chapter 120, no person, other
447	than the provider, the escrow agent, and the office, may shall
448	have a substantial interest in any office decision regarding
449	release of escrow funds in any proceedings under chapter 120 or
450	this chapter regarding release of escrow funds.
451	(7)(5)  In lieu of the provider fulfilling the requirements
452	in subsection (5) (3) and paragraphs (6)(4)(b) and (d), the
453	office may authorize the release of escrowed funds to retire all
454	outstanding debts on the facility and equipment upon application
455	of the provider and upon the provider's showing that the
456	provider will grant to the residents a first mortgage on the
457	land, buildings, and equipment that constitute the facility, and
458	that the provider has satisfied satisfies the requirements of
459	paragraphs (6)(4)(a), (c), and (e). Such mortgage shall secure
460	the refund of the entrance fee in the amount required by this
461	chapter. The granting of such mortgage is shall be subject to
462	the following:
463	(a)  The first mortgage is shall be granted to an
464	independent trust that which is beneficially held by the
465	residents. The document creating the trust must include shall
466	contain a provision that it agrees to an annual audit and will
467	furnish to the office all information the office may reasonably
468	require. The mortgage may secure payment on bonds issued to the
469	residents or trustee. Such bonds are shall be redeemable after
470	termination of the residency contract in the amount and manner
471	required by this chapter for the refund of an entrance fee.
472	(b)  Before granting a first mortgage to the residents, all
473	construction must shall be substantially completed and
474	substantially all equipment must shall be purchased. No part of
475	the entrance fees may be pledged as security for a construction
476	loan or otherwise used for construction expenses before the
477	completion of construction.
478	(c)  If the provider is leasing the land or buildings used
479	by the facility, the leasehold interest must shall be for a term
480	of at least 30 years.
481	(8)(6)  The timeframes provided under s. 651.022(5) and (6)
482	apply to applications submitted under s. 651.021(2). The office
483	may not issue a certificate of authority under this chapter to a
484	any facility that which does not have a component that which is
485	to be licensed pursuant to part II of chapter 400 or to part I
486	of chapter 429 or that does which will not offer personal
487	services or nursing services through written contractual
488	agreement. A Any written contractual agreement must be disclosed
489	in the continuing care contract for continuing care or
490	continuing care at-home and is subject to the provisions of s.
491	651.1151, relating to administrative, vendor, and management
492	contracts.
493	(9)(7)  The office may shall not approve an application
494	that which includes in the plan of financing any encumbrance of
495	the operating reserves required by this chapter.
496	Section 7.  Paragraphs (a) and (d) of subsection (3) of
497	section 651.033, Florida Statutes, are amended to read:
498	651.033  Escrow accounts.-
499	(3)  In addition, when entrance fees are required to be
500	deposited in an escrow account pursuant to s. 651.022, s.
501	651.023, or s. 651.055:
502	(a)  The provider shall deliver to the resident a written
503	receipt. The receipt must shall show the payor's name and
504	address, the date, the price of the care contract, and the
505	amount of money paid. A copy of each receipt, together with the
506	funds, shall be deposited with the escrow agent or as provided
507	in paragraph (c). The escrow agent shall release such funds to
508	the provider upon the expiration of 7 days after the date of
509	receipt of the funds by the escrow agent if the provider,
510	operating under a certificate of authority issued by the office,
511	has met the requirements of s. 651.023(6)(4). However, if the
512	resident rescinds the contract within the 7-day period, the
513	escrow agent shall release the escrowed fees to the resident.
514	(d)  A provider may assess a nonrefundable fee, which is
515	separate from the entrance fee, for processing a prospective
516	resident's application for continuing care or continuing care
517	at-home.
518	Section 8.  Subsections (2) and (3) of section 651.035,
519	Florida Statutes, are amended to read:
520	651.035  Minimum liquid reserve requirements.-
521	(2)(a)  In facilities where not all residents are under
522	continuing care or continuing care at-home contracts, the
523	reserve requirements of subsection (1) shall be computed only
524	with respect to the proportional share of operating expenses
525	that which are applicable to residents as defined in s. 651.011.
526	For purposes of this calculation, the proportional share shall
527	be based upon the ratio of residents under continuing care or
528	continuing care at-home contracts to those residents who do not
529	hold such contracts.
530	(b)  In facilities that have voluntarily and permanently
531	discontinued marketing continuing care and continuing care at-
532	home contracts, the office may allow a reduced debt service
533	reserve as required in subsection (1) based upon the ratio of
534	residents under continuing care or continuing care at-home
535	contracts to those residents who do not hold such contracts if
536	the office finds that such reduction is not inconsistent with
537	the security protections intended by this chapter. In making
538	this determination, the office may consider such factors as the
539	financial condition of the facility, the provisions of the
540	outstanding continuing care and continuing care at-home
541	contracts, the ratio of residents under continuing care or
542	continuing care at-home contracts agreements to those residents
543	who do not hold such contracts a continuing care contract, the
544	current occupancy rates, the previous sales and marketing
545	efforts, the life expectancy of the remaining residents contract
546	holders, and the written policies of the board of directors of
547	the provider or a similar board.
548	(3)  If principal and interest payments are paid to a trust
549	that is beneficially held by the residents as described in s.
550	651.023(7)(5), the office may waive all or any portion of the
551	escrow requirements for mortgage principal and interest
552	contained in subsection (1) if the office finds that such waiver
553	is not inconsistent with the security protections intended by
554	this chapter.
555	Section 9.  Section 651.055, Florida Statutes, is amended
556	to read:
557	651.055  Continuing care contracts; right to rescind.-
558	(1)  Each continuing care contract and each addendum to
559	such contract shall be submitted to and approved by the office
560	before prior to its use in this state. Thereafter, no other form
561	of contract shall be used by the provider until unless it has
562	been submitted to and approved by the office. Each contract must
563	shall:
564	(a)  Provide for the continuing care of only one resident,
565	or for two persons occupying space designed for double
566	occupancy, under appropriate regulations established by the
567	provider, and must shall list all properties transferred and
568	their market value at the time of transfer, including donations,
569	subscriptions, fees, and any other amounts paid or payable by,
570	or on behalf of, the resident or residents.
571	(b)  Specify all services that which are to be provided by
572	the provider to each resident, including, in detail, all items
573	that which each resident will receive, whether the items will be
574	provided for a designated time period or for life, and whether
575	the services will be available on the premises or at another
576	specified location. The provider shall indicate which services
577	or items are included in the contract for continuing care and
578	which services or items are made available at or by the facility
579	at extra charge. Such items shall include, but are not limited
580	to, food, shelter, personal services or nursing care, drugs,
581	burial, and incidentals.
582	(c)  Describe the terms and conditions under which a
583	contract for continuing care may be canceled by the provider or
584	by a resident and the conditions, if any, under which all or any
585	portion of the entrance fee will be refunded in the event of
586	cancellation of the contract by the provider or by the resident,
587	including the effect of any change in the health or financial
588	condition of a person between the date of entering a contract
589	for continuing care and the date of initial occupancy of a
590	living unit by that person.
591	(d)  Describe the health and financial conditions required
592	for a person to be accepted as a resident and to continue as a
593	resident, once accepted, including the effect of any change in
594	the health or financial condition of the person between the date
595	of submitting an application for admission to the facility and
596	entering into a continuing care contract. If a prospective
597	resident signs a contract but postpones moving into the
598	facility, the individual is deemed to be occupying a unit at the
599	facility when he or she pays the entrance fee or any portion of
600	the fee, other than a reservation deposit, and begins making
601	monthly maintenance fee payments. Such resident may rescind the
602	contract and receive a full refund of any funds paid, without
603	penalty or forfeiture, within 7 days after executing the
604	contract as specified in subsection (2).
605	(e)  Describe the circumstances under which the resident
606	will be permitted to remain in the facility in the event of
607	financial difficulties of the resident. The stated policy may
608	not be less than the terms stated in s. 651.061.
609	(f)  State the fees that will be charged if the resident
610	marries while at the designated facility, the terms concerning
611	the entry of a spouse to the facility, and the consequences if
612	the spouse does not meet the requirements for entry.
613	(g)  Provide that the contract may be canceled by giving at
614	least 30 days' written notice of cancellation by the provider,
615	the resident, or the person who provided the transfer of
616	property or funds for the care of such resident.; However, if a
617	contract is canceled because there has been a good faith
618	determination that a resident is a danger to himself or herself
619	or others, only such notice as is reasonable under the
620	circumstances is required.
621	1.  The contract must also provide in clear and
622	understandable language, in print no smaller than the largest
623	type used in the body of the contract, the terms governing the
624	refund of any portion of the entrance fee.
625	2.  For a resident whose contract with the facility
626	provides that the resident does not receive a transferable
627	membership or ownership right in the facility, and who has
628	occupied his or her unit, the refund shall be calculated on a
629	pro rata basis with the facility retaining up to 2 percent per
630	month of occupancy by the resident and up to a 5 percent 5-
631	percent processing fee. Such refund must be paid within 120 days
632	after giving the notice of intention to cancel.
633	3.  In addition to a processing fee, if the contract
634	provides for the facility to retain up to 1 percent per month of
635	occupancy by the resident, it may provide that such refund will
636	be paid from the proceeds of the next entrance fees received by
637	the provider for units for which there are no prior claims by
638	any resident until paid in full or, if the provider has
639	discontinued marketing continuing care contracts, within 200
640	days after the date of notice.
641	4.  Unless subsection (5) applies, for any prospective
642	resident, regardless of whether or not such a resident receives
643	a transferable membership or ownership right in the facility,
644	who cancels the contract before occupancy of the unit, the
645	entire amount paid toward the entrance fee shall be refunded,
646	less a processing fee of up to 5 percent of the entire entrance
647	fee; however, the processing fee may not exceed the amount paid
648	by the prospective resident. Such refund must be paid within 60
649	days after giving the notice of intention to cancel. For a
650	resident who has occupied his or her unit and who has received a
651	transferable membership or ownership right in the facility, the
652	foregoing refund provisions do not apply but are deemed
653	satisfied by the acquisition or receipt of a transferable
654	membership or an ownership right in the facility. The provider
655	may not charge any fee for the transfer of membership or sale of
656	an ownership right.
657	(h)  State the terms under which a contract is canceled by
658	the death of the resident. These terms may contain a provision
659	that, upon the death of a resident, the entrance fee of such
660	resident is shall be considered earned and becomes shall become
661	the property of the provider. If When the unit is shared, the
662	conditions with respect to the effect of the death or removal of
663	one of the residents must shall be included in the contract.
664	(i)  Describe the policies that which may lead to changes
665	in monthly recurring and nonrecurring charges or fees for goods
666	and services received. The contract must shall provide for
667	advance notice to the resident, of at least not less than 60
668	days, before any change in fees or charges or the scope of care
669	or services is may be effective, except for changes required by
670	state or federal assistance programs.
671	(j)  Provide that charges for care paid in one lump sum may
672	shall not be increased or changed during the duration of the
673	agreed upon care, except for changes required by state or
674	federal assistance programs.
675	(k)  Specify whether or not the facility is, or is
676	affiliated with, a religious, nonprofit, or proprietary
677	organization or management entity; the extent to which the
678	affiliate organization will be responsible for the financial and
679	contractual obligations of the provider; and the provisions of
680	the federal Internal Revenue Code, if any, under which the
681	provider or affiliate is exempt from the payment of federal
682	income tax.
683	(2)  A resident has the right to rescind a continuing care
684	contract and receive a full refund of any funds paid, without
685	penalty or forfeiture, within 7 days after executing the
686	contract. A resident may not be required to move into the
687	facility designated in the contract before the expiration of the
688	7-day period. During the 7-day period, the resident's funds must
689	be held in an escrow account unless otherwise requested by the
690	resident pursuant to s. 651.033(3)(c).
691	(3)  The contract must shall include or shall be
692	accompanied by a statement, printed in boldfaced type, which
693	reads: "This facility and all other continuing care facilities
694	in the State of Florida are regulated by chapter 651, Florida
695	Statutes. A copy of the law is on file in this facility. The law
696	gives you or your legal representative the right to inspect our
697	most recent financial statement and inspection report before
698	signing the contract."
699	(4)  Before the transfer of any money or other property to
700	a provider by or on behalf of a prospective resident, the
701	provider shall present a typewritten or printed copy of the
702	contract to the prospective resident and all other parties to
703	the contract. The provider shall secure a signed, dated
704	statement from each party to the contract certifying that a copy
705	of the contract with the specified attachment, as required
706	pursuant to this chapter, was received.
707	(5)  Except for a resident who postpones moving into the
708	facility but is deemed to have occupied a unit as described in
709	paragraph (1)(d), if a prospective resident dies before
710	occupying the facility or, through illness, injury, or
711	incapacity, is precluded from becoming a resident under the
712	terms of the continuing care contract, the contract is
713	automatically canceled, and the prospective resident or his or
714	her legal representative shall receive a full refund of all
715	moneys paid to the facility, except those costs specifically
716	incurred by the facility at the request of the prospective
717	resident and set forth in writing in a separate addendum, signed
718	by both parties, to the contract.
719	(6)  In order to comply with this section, a provider may
720	furnish information not contained in his or her continuing care
721	contract through an addendum.
722	(7)  Contracts to provide continuing care, including
723	contracts that are terminable by either party, may include
724	agreements to provide care for any duration.
725	(8)(7)  Those contracts entered into after subsequent to
726	July 1, 1977, and before the issuance of a certificate of
727	authority to the provider are valid and binding upon both
728	parties in accordance with their terms. Within 30 days after
729	receipt of a letter from the office notifying the provider of a
730	noncompliant residency contract, the provider shall file a new
731	residency contract for approval that complies with Florida law.
732	Pending review and approval of the new residency contract, the
733	provider may continue to use the previously approved contract.
734	(9)  A prospective resident, resident, or resident's estate
735	is not entitled to interest of any type on a deposit or entrance
736	fee unless interest is specified in the continuing care
737	contract. This subsection is remedial in nature and clarifies
738	existing law.
739	(10)(8)  The provisions of this section shall control over
740	any conflicting provisions contained in part II of chapter 400
741	or in part I of chapter 429.
742	Section 10.  Section 651.057, Florida Statutes, is created
743	to read:
744	651.057  Continuing care at-home contracts.-
745	(1)  In addition to the requirements of s. 651.055, a
746	provider offering contracts for continuing care at-home must:
747	(a)  Disclose the following in the continuing care at-home
748	contract:
749	1.  Whether transportation will be provided to residents
750	when traveling to and from the facility for services;
751	2.  That the provider has no liability for residents
752	residing outside the facility beyond the delivery of services
753	specified in the contract and future access to nursing care or
754	personal services at the facility or in another setting
755	designated in the contract;
756	3.  The mechanism for monitoring residents who live outside
757	the facility;
758	4.  The process that will be followed to establish priority
759	if a resident wishes to exercise his or her right to move into
760	the facility; and
761	5.  The policy that will be followed if a resident living
762	outside the facility relocates to a different residence and no
763	longer avails himself or herself of services provided by the
764	facility.
765	(b)  Ensure that persons employed by or under contract with
766	the provider who assist in the delivery of services to residents
767	residing outside the facility are appropriately licensed or
768	certified as required by law.
769	(c)  Include operating expenses for continuing care at-home
770	contracts in the calculation of the operating reserve required
771	by s. 651.035(1)(c).
772	(d)  Include the operating activities for continuing care
773	at-home contracts in the total operation of the facility when
774	submitting financial reports to the office as required by s.
775	651.026.
776	(2)  A provider that holds a certificate of authority and
777	wishes to offer continuing care at-home must also:
778	(a)  Submit a business plan to the office with the
779	following information:
780	1.  A description of the continuing care at-home services
781	that will be provided, the market to be served, and the fees to
782	be charged;
783	2.  A copy of the proposed continuing care at-home
784	contract;
785	3.  An actuarial study prepared by an independent actuary
786	in accordance with the standards adopted by the American Academy
787	of Actuaries which presents the impact of providing continuing
788	care at-home on the overall operation of the facility; and
789	4.  A market feasibility study that meets the requirements
790	of s. 651.022(3) and documents that there is sufficient interest
791	in continuing care at-home contracts to support such a program;
792	(b)  Demonstrate to the office that the proposal to offer
793	continuing care at-home contracts to individuals who do not
794	immediately move into the facility will not place the provider
795	in an unsound financial condition;
796	(c)  Comply with the requirements of s. 651.021(2), except
797	that an actuarial study may be substituted for the feasibility
798	study; and
799	(d)  Comply with the requirements of this chapter.
800	(3)  Contracts to provide continuing care at-home,
801	including contracts that are terminable by either party, may
802	include agreements to provide care for any duration.
803	(4)  A provider offering continuing care at-home contracts
804	must, at a minimum, have a facility that is licensed under this
805	chapter and has accommodations for independent living which are
806	primarily intended for residents who do not require staff
807	supervision. The facility need not offer assisted living units
808	licensed under part I of chapter 429 or nursing home units
809	licensed under part II of chapter 400 in order to be able to
810	offer continuing care at-home contracts.
811	(a)  The combined number of outstanding continuing care
812	(CCRC) and continuing care at-home (CCAH) contracts allowed at
813	the facility may be the greater of:
814	1.  One and one-half times the combined number of
815	independent living units (ILU), assisted living units (ALF) that
816	are licensed under part I of chapter 429, and nursing home units
817	licensed under part II of chapter 400 at the facility; or
818	2.  Four times the combined number of assisted living units
819	(ALF) that are licensed under part I of chapter 429 and nursing
820	home units that are licensed under part II of chapter 400 at
821	that facility.
822	(b)  The number of independent living units at the facility
823	must be equal to or greater than 10 percent of the initial 100
824	continuing care (CCRC) and continuing care at-home (CCAH)
825	contracts and 5 percent of the combined number of outstanding
826	continuing care (CCRC) and continuing care at-home (CCAH)
827	contracts in excess of 100 issued by that facility.
828	Section 11.  Subsection (1) of section 651.071, Florida
829	Statutes, is amended to read:
830	651.071  Contracts as preferred claims on liquidation or
831	receivership.-
832	(1)  In the event of receivership or liquidation
833	proceedings against a provider, all continuing care and
834	continuing care at-home contracts executed by a provider shall
835	be deemed preferred claims against all assets owned by the
836	provider; however, such claims are shall be subordinate to those
837	priority claims set forth in s. 631.271 and any secured claim as
838	defined in s. 631.011.
839	Section 12.  Paragraph (h) of subsection (2) and subsection
840	(3) of section 651.091, Florida Statutes, are amended to read:
841	651.091  Availability, distribution, and posting of reports
842	and records; requirement of full disclosure.-
843	(2)  Every continuing care facility shall:
844	(h)  Upon request, deliver to the president or chair of the
845	residents' council a copy of any newly approved continuing care
846	or continuing care at-home contract within 30 days after
847	approval by the office.
848	(3)  Before entering into a contract to furnish continuing
849	care or continuing care at-home, the provider undertaking to
850	furnish the care, or the agent of the provider, shall make full
851	disclosure, and provide copies of the disclosure documents to
852	the prospective resident or his or her legal representative, of
853	the following information:
854	(a)  The contract to furnish continuing care or continuing
855	care at-home.
856	(b)  The summary listed in paragraph (2)(b).
857	(c)  All ownership interests and lease agreements,
858	including information specified in s. 651.022(2)(b)8.
859	(d)  In keeping with the intent of this subsection relating
860	to disclosure, the provider shall make available for review,
861	master plans approved by the provider's governing board and any
862	plans for expansion or phased development, to the extent that
863	the availability of such plans do will not put at risk real
864	estate, financing, acquisition, negotiations, or other
865	implementation of operational plans and thus jeopardize the
866	success of negotiations, operations, and development.
867	(e)  Copies of the rules and regulations of the facility
868	and an explanation of the responsibilities of the resident.
869	(f)  The policy of the facility with respect to admission
870	to and discharge from the various levels of health care offered
871	by the facility.
872	(g)  The amount and location of any reserve funds required
873	by this chapter, and the name of the person or entity having a
874	claim to such funds in the event of a bankruptcy, foreclosure,
875	or rehabilitation proceeding.
876	(h)  A copy of s. 651.071.
877	(i)  A copy of the resident's rights as described in s.
878	651.083.
879	Section 13.  Section 651.106, Florida Statutes, is amended
880	to read:
881	651.106  Grounds for discretionary refusal, suspension, or
882	revocation of certificate of authority.-The office, in its
883	discretion, may deny, suspend, or revoke the provisional
884	certificate of authority or the certificate of authority of any
885	applicant or provider if it finds that any one or more of the
886	following grounds applicable to the applicant or provider exist:
887	(1)  Failure by the provider to continue to meet the
888	requirements for the authority originally granted.
889	(2)  Failure by the provider to meet one or more of the
890	qualifications for the authority specified by this chapter.
891	(3)  Material misstatement, misrepresentation, or fraud in
892	obtaining the authority, or in attempting to obtain the same.
893	(4)  Demonstrated lack of fitness or trustworthiness.
894	(5)  Fraudulent or dishonest practices of management in the
895	conduct of business.
896	(6)  Misappropriation, conversion, or withholding of
897	moneys.
898	(7)  Failure to comply with, or violation of, any proper
899	order or rule of the office or commission or violation of any
900	provision of this chapter.
901	(8)  The insolvent condition of the provider or the
902	provider's being in such condition or using such methods and
903	practices in the conduct of its business as to render its
904	further transactions in this state hazardous or injurious to the
905	public.
906	(9)  Refusal by the provider to be examined or to produce
907	its accounts, records, and files for examination, or refusal by
908	any of its officers to give information with respect to its
909	affairs or to perform any other legal obligation under this
910	chapter when required by the office.
911	(10)  Failure by the provider to comply with the
912	requirements of s. 651.026 or s. 651.033.
913	(11)  Failure by the provider to maintain escrow accounts
914	or funds as required by this chapter.
915	(12)  Failure by the provider to meet the requirements of
916	this chapter for disclosure of information to residents
917	concerning the facility, its ownership, its management, its
918	development, or its financial condition or failure to honor its
919	continuing care or continuing care at-home contracts.
920	(13)  Any cause for which issuance of the license could
921	have been refused had it then existed and been known to the
922	office.
923	(14)  Having been found guilty of, or having pleaded guilty
924	or nolo contendere to, a felony in this state or any other
925	state, without regard to whether a judgment or conviction has
926	been entered by the court having jurisdiction of such cases.
927	(15)  In the conduct of business under the license,
928	engaging in unfair methods of competition or in unfair or
929	deceptive acts or practices prohibited under part IX of chapter
930	626.
931	(16)  A pattern of bankrupt enterprises.
932
933	Revocation of a certificate of authority under this section does
934	not relieve a provider from the provider's obligation to
935	residents under the terms and conditions of any continuing care
936	or continuing care at-home contract between the provider and
937	residents or the provisions of this chapter. The provider shall
938	continue to file its annual statement and pay license fees to
939	the office as required under this chapter as if the certificate
940	of authority had continued in full force, but the provider shall
941	not issue any new continuing care contracts. The office may seek
942	an action in the circuit court of Leon County to enforce the
943	office's order and the provisions of this section.
944	Section 14.  Subsection (8) of section 651.114, Florida
945	Statutes, is amended to read:
946	651.114  Delinquency proceedings; remedial rights.-
947	(8)(a)  The rights of the office described in this section
948	are shall be subordinate to the rights of a trustee or lender
949	pursuant to the terms of a resolution, ordinance, loan
950	agreement, indenture of trust, mortgage, lease, security
951	agreement, or other instrument creating or securing bonds or
952	notes issued to finance a facility, and the office, subject to
953	the provisions of paragraph (c), shall not exercise its remedial
954	rights provided under this section and ss. 651.018, 651.106,
955	651.108, and 651.116 with respect to a facility that is subject
956	to a lien, mortgage, lease, or other encumbrance or trust
957	indenture securing bonds or notes issued in connection with the
958	financing of the facility, if the trustee or lender, by
959	inclusion or by amendment to the loan documents or by a separate
960	contract with the office, agrees that the rights of residents
961	under a continuing care or continuing care at-home contract will
962	be honored and will not be disturbed by a foreclosure or
963	conveyance in lieu thereof as long as the resident:
964	1.  Is current in the payment of all monetary obligations
965	required by the continuing care contract;
966	2.  Is in compliance and continues to comply with all
967	provisions of the resident's continuing care contract; and
968	3.  Has asserted no claim inconsistent with the rights of
969	the trustee or lender.
970	(b)  Nothing in This subsection does not require requires a
971	trustee or lender to:
972	1.  Continue to engage in the marketing or resale of new
973	continuing care or continuing care at-home contracts;
974	2.  Pay any rebate of entrance fees as may be required by a
975	resident's continuing care or continuing care at-home contract
976	as of the date of acquisition of the facility by the trustee or
977	lender and until expiration of the period described in paragraph
978	(d);
979	3.  Be responsible for any act or omission of any owner or
980	operator of the facility arising before prior to the acquisition
981	of the facility by the trustee or lender; or
982	4.  Provide services to the residents to the extent that
983	the trustee or lender would be required to advance or expend
984	funds that have not been designated or set aside for such
985	purposes.
986	(c)  Should the office determine, at any time during the
987	suspension of its remedial rights as provided in paragraph (a),
988	that the trustee or lender is not in compliance with the
989	provisions of paragraph (a), or that a lender or trustee has
990	assigned or has agreed to assign all or a portion of a
991	delinquent or defaulted loan to a third party without the
992	office's written consent, the office shall notify the trustee or
993	lender in writing of its determination, setting forth the
994	reasons giving rise to the determination and specifying those
995	remedial rights afforded to the office which the office shall
996	then reinstate.
997	(d)  Upon acquisition of a facility by a trustee or lender
998	and evidence satisfactory to the office that the requirements of
999	paragraph (a) have been met, the office shall issue a 90-day
1000	temporary certificate of authority granting the trustee or
1001	lender the authority to engage in the business of providing
1002	continuing care or continuing care at-home and to issue
1003	continuing care or continuing care at-home contracts subject to
1004	the office's right to immediately suspend or revoke the
1005	temporary certificate of authority if the office determines that
1006	any of the grounds described in s. 651.106 apply to the trustee
1007	or lender or that the terms of the contract agreement used as
1008	the basis for the issuance of the temporary certificate of
1009	authority by the office have not been or are not being met by
1010	the trustee or lender since the date of acquisition.
1011	Section 15.  Subsections (4), (7), (9), and (11) of section
1012	651.118, Florida Statutes, are amended to read:
1013	651.118  Agency for Health Care Administration;
1014	certificates of need; sheltered beds; community beds.-
1015	(4)  Not including the residences of residents residing
1016	outside the facility pursuant to a continuing care at-home
1017	contract, the Agency for Health Care Administration shall
1018	approve one sheltered nursing home bed for every four proposed
1019	residential units, including those that are licensed under part
1020	I of chapter 429, in the continuing care facility unless the
1021	provider demonstrates the need for a lesser number of sheltered
1022	nursing home beds based on proposed utilization by prospective
1023	residents or demonstrates the need for additional sheltered
1024	nursing home beds based on actual utilization and demand by
1025	current residents.
1026	(7)  Notwithstanding the provisions of subsection (2), at
1027	the discretion of the continuing care provider, sheltered
1028	nursing home beds may be used for persons who are not residents
1029	of the continuing care facility and who are not parties to a
1030	continuing care contract for a period of up to 5 years after the
1031	date of issuance of the initial nursing home license. A provider
1032	whose 5-year period has expired or is expiring may request an
1033	extension from the Agency for Health Care Administration for an
1034	extension, not to exceed 30 percent of the total sheltered
1035	nursing home beds or 30 sheltered beds, whichever is greater, if
1036	the utilization by residents of the nursing home facility in the
1037	sheltered beds will not generate sufficient income to cover
1038	nursing home facility expenses, as evidenced by one of the
1039	following:
1040	(a)  The nursing home facility has a net loss for the most
1041	recent fiscal year as determined under generally accepted
1042	accounting principles, excluding the effects of extraordinary or
1043	unusual items, as demonstrated in the most recently audited
1044	financial statement.; or
1045	(b)  The nursing home facility would have had a pro forma
1046	loss for the most recent fiscal year, excluding the effects of
1047	extraordinary or unusual items, if revenues were reduced by the
1048	amount of revenues from persons in sheltered beds who were not
1049	residents, as reported on by a certified public accountant.
1050
1051	The Agency for Health Care Administration may shall be
1052	authorized to grant an extension to the provider based on the
1053	evidence required in this subsection. The Agency for Health Care
1054	Administration may request a continuing care facility to use up
1055	to 25 percent of the patient days generated by new admissions of
1056	nonresidents during the extension period to serve Medicaid
1057	recipients for those beds authorized for extended use if there
1058	is a demonstrated need in the respective service area and if
1059	funds are available. A provider who obtains an extension is
1060	prohibited from applying for additional sheltered beds under the
1061	provision of subsection (2), unless additional residential units
1062	are built or the provider can demonstrate need by continuing
1063	care facility residents to the Agency for Health Care
1064	Administration. The 5-year limit does not apply to up to five
1065	sheltered beds designated for inpatient hospice care as part of
1066	a contractual arrangement with a hospice licensed under part IV
1067	of chapter 400. A continuing care facility that uses such beds
1068	after the 5-year period shall report such use to the Agency for
1069	Health Care Administration. For purposes of this subsection,
1070	"resident" means a person who, upon admission to the continuing
1071	care facility, initially resides in a part of the continuing
1072	care facility not licensed under part II of chapter 400, or who
1073	contracts for continuing care at-home.
1074	(9)  This section does not preclude a continuing care
1075	provider from applying to the Agency for Health Care
1076	Administration for a certificate of need for community nursing
1077	home beds or a combination of community and sheltered nursing
1078	home beds. Any nursing home bed located in a continuing care
1079	facility which that is or has been issued for nonrestrictive use
1080	retains shall retain its legal status as a community nursing
1081	home bed unless the provider requests a change in status. Any
1082	nursing home bed located in a continuing care facility and not
1083	issued as a sheltered nursing home bed before prior to 1979 must
1084	be classified as a community bed. The Agency for Health Care
1085	Administration may require continuing care facilities to submit
1086	bed utilization reports for the purpose of determining community
1087	and sheltered nursing home bed inventories based on historical
1088	utilization by residents and nonresidents.
1089	(11)  For a provider issued a provisional certificate of
1090	authority after July 1, 1986, to operate a facility not
1091	previously regulated under this chapter, the following criteria
1092	must shall be met in order to obtain a certificate of need for
1093	sheltered beds pursuant to subsections (2), (3), (4), (5), (6),
1094	and (7):
1095	(a)  Seventy percent or more of the current residents hold
1096	continuing care or continuing care at-home contracts agreements
1097	pursuant to s. 651.011(2) or, if the facility is not occupied,
1098	70 percent or more of the prospective residents will hold such
1099	contracts continuing care agreements pursuant to s. 651.011(2)
1100	as projected in the feasibility study and demonstrated by the
1101	provider's marketing practices; and
1102	(b)  The continuing care or continuing care at-home
1103	contracts agreements entered into or to be entered into by 70
1104	percent or more of the current residents or prospective
1105	residents must pursuant to s. 651.011(2) shall provide nursing
1106	home care for a minimum of 360 cumulative days, and such
1107	residents the holders of the continuing care agreements shall be
1108	charged at rates that which are 80 percent or less than the
1109	rates charged by the provider to persons receiving nursing home
1110	care who have not entered into such contracts continuing care
1111	agreements pursuant to s. 651.011(2).
1112	Section 16.  Subsection (1) of section 651.121, Florida
1113	Statutes, is amended to read:
1114	651.121  Continuing Care Advisory Council.-
1115	(1)  The Continuing Care Advisory Council to the office is
1116	created consisting to consist of 10 members who are residents of
1117	this state appointed by the Governor and geographically
1118	representative of this state. Three members shall be
1119	administrators of facilities that hold valid certificates of
1120	authority under this chapter and shall have been actively
1121	engaged in the offering of continuing care contracts agreements
1122	in this state for 5 years before appointment. The remaining
1123	members include:
1124	(a)  A representative of the business community whose
1125	expertise is in the area of management.
1126	(b)  A representative of the financial community who is not
1127	a facility owner or administrator.
1128	(c)  A certified public accountant.
1129	(d)  An attorney.
1130	(e)  Three residents who hold continuing care or continuing
1131	care at-home contracts agreements with a facility certified in
1132	this state.
1133	Section 17.  Subsection (1) of section 651.125, Florida
1134	Statutes, is amended to read:
1135	651.125  Criminal penalties; injunctive relief.-
1136	(1)  Any person who maintains, enters into, or, as manager
1137	or officer or in any other administrative capacity, assists in
1138	entering into, maintaining, or performing any continuing care or
1139	continuing care at-home contract agreement subject to this
1140	chapter without doing so in pursuance of a valid certificate of
1141	authority or renewal thereof, as contemplated by or provided in
1142	this chapter, or who otherwise violates any provision of this
1143	chapter or rule adopted in pursuance of this chapter, commits is
1144	guilty of a felony of the third degree, punishable as provided
1145	in s. 775.082 or s. 775.083. Each violation of this chapter
1146	constitutes a separate offense.
1147	Section 18.  This act shall take effect July 1, 2011.

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