Amendment
Bill No. CS/CS/HB 119

Amendment No. 956799

CHAMBER ACTION
Senate		House
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1	Representative Jones offered the following:
2
3	Amendment to Amendment (397883) (with title amendment)
4	Between lines 181 and 182, insert:
5	Section 4.  Section 400.1411, Florida Statutes, is created
6	to read:
7	400.1411  Financial responsibility.-
8	(1)  As a condition of licensing and maintaining an active
9	license, and prior to the issuance or renewal of an active
10	license or reactivation of an inactive license for operating a
11	nursing home facility in this state, an applicant must, by one
12	of the following methods, demonstrate to the satisfaction of the
13	agency and the former Department of Insurance financial
14	responsibility to pay claims and costs ancillary thereto arising
15	out of the rendering of, or the failure to render, care or
16	services:
17	(a)  Establishing and maintaining an escrow account
18	consisting of cash or assets eligible for deposit in accordance
19	with s. 625.52 in the per claim amounts specified in paragraph
20	(b). The required escrow amount set forth in this paragraph may
21	not be used for litigation costs and attorneys' fees for the
22	defense of any claim maintained pursuant to common law, s.
23	400.23, or s. 400.0233.
24	(b)  Obtaining and maintaining general and professional
25	liability coverage in an amount not less than $500,000 per
26	claim, with a minimum annual aggregate of not less than $1
27	million from an authorized insurer as defined under s. 624.09,
28	from a surplus lines insurer as defined under s. 626.914(2),
29	from a risk retention group as defined under s. 627.942, or
30	through a plan of self-insurance as defined in s. 627.357.
31	However, any nursing home facility that obtains general and
32	professional liability insurance coverage from a risk retention
33	group as defined under s. 627.942 is only required to maintain
34	general and professional liability insurance coverage in an
35	amount not less than $250,000 per claim, with a minimum annual
36	aggregate of not less than $500,000. Furthermore, any nursing
37	home facility that has been awarded a Gold Seal under the
38	program established in s. 400.235 is only required to maintain
39	general and professional liability insurance coverage in an
40	amount not less than $250,000 per claim, with a minimum annual
41	aggregate of not less than $500,000, from an authorized insurer
42	as defined under s. 626.914(2), from a risk retention group as
43	defined under s. 627.942, or through a plan of self-insurance as
44	defined in s. 627.357. The required coverage amount set forth in
45	this paragraph may not be used for litigation costs and
46	attorneys' fees for the defense of any claim maintained pursuant
47	to common law, s. 400.023, or s. 400.0233.
48	(c)  Obtaining and maintaining an unexpired, irrevocable
49	letter of credit, established pursuant to chapter 675, in an
50	amount not less than $500,000 per claim, with a minimum
51	aggregate availability of credit not less than $1 million.
52	However, any nursing home facility that has been awarded a Gold
53	Seal under the program established in s. 400.235 is only
54	required to maintain an unexpired, irrevocable letter of credit,
55	established pursuant to chapter 675, in an amount not less than
56	$250,000 per claim, with a minimum annual aggregate of
57	availability of credit not less than $500,000. The letter of
58	credit must be payable to the nursing home facility as
59	beneficiary upon presentment of a final judgment indicating
60	liability and awarding damages to be paid by the nursing home
61	facility or upon presentment of a settlement agreement signed by
62	all parties to such agreement when such final judgment or
63	settlement is a result of a claim arising out of the rendering
64	of, or the failure to render, care and services. The letter of
65	credit shall not be used for litigation costs and attorneys'
66	fees for the defense of any claim maintained pursuant to common
67	law, s. 400.023, or s. 400.0233. The letter of credit must be
68	nonassignable and nontransferable. Such letter of credit must be
69	issued by a bank or savings association organized and existing
70	under the laws of this state or any bank or savings association
71	organized under the laws of the United States that has its
72	principal place of business in this state or has a branch office
73	that is authorized under the laws of this state or of the United
74	States to receive deposits in this state.
75	(2)(a)  Each insurer, self-insurer, or risk retention group
76	must promptly notify the agency and the former Department of
77	Insurance of cancellation or nonrenewal of insurance required by
78	this section. Unless the nursing home facility demonstrates that
79	it is otherwise in compliance with the requirements of this
80	section, the agency shall suspend the license of the nursing
81	home facility. Any suspension under this subsection remains in
82	effect until the nursing home facility demonstrates compliance
83	with the requirements of this section. If any judgments or
84	settlements are pending at the time of suspension of the
85	license, those judgments or settlements must be paid in
86	accordance with this section unless otherwise mutually agreed to
87	in writing by the parties. This paragraph does not arrogate a
88	judgment debtor's obligation to satisfy the entire amount of any
89	judgment.
90	(b)  If financial responsibility requirements are met by
91	maintaining an escrow account or letter of credit as provided in
92	this section, upon the entry of an adverse final judgment
93	arising from a claim maintained in contract or in tort pursuant
94	to common law, s. 400.023, or s. 400.0233, or from noncompliance
95	with the terms of a settlement agreement arising from a claim
96	maintained in contract or in tort pursuant to common law, s.
97	400.023, or s. 400.0233, the licensee of the nursing home
98	facility, the nursing home facility, or the entity that owns,
99	operates, manages, or controls the nursing home facility shall
100	pay the entire amount of the judgment together with all accrued
101	interest or the amount maintained in the escrow account or
102	provided in the letter of credit as required by this section,
103	whichever is less, within 60 days after the date such judgment
104	became final and subject to execution, unless otherwise mutually
105	agreed to in writing by the parties. If timely payment is not
106	made by the licensee of the nursing home facility, the nursing
107	home facility or the entity that owns, operates, manages, or
108	controls the nursing home facility, the agency shall suspend the
109	license of the nursing home facility. This paragraph does not
110	abrogate a judgment debtor's obligation to satisfy the entire
111	amount of any judgment.
112	(3)  Upon the entry of an adverse final judgment arising
113	from a claim maintained in contract or in tort pursuant to
114	common law, s. 400.023, s. 400.0233, or from noncompliance with
115	the terms of a settlement agreement arising from a claim
116	maintained in contract or in tort pursuant to common law, s.
117	400.023, or s. 400.0233, the licensee of the nursing home
118	facility, the nursing home facility, or the entity that owns,
119	operates, manages or controls the nursing home facility shall
120	pay the judgment creditor the lesser of the entire amount of the
121	judgment with all accrued interest or the per claim amounts
122	specified in paragraph (1)(b), within 60 days after the date
123	such judgment became final and subject to execution, unless
124	otherwise mutually agreed to in writing by the parties. Such
125	adverse final judgment shall include any cross-claims,
126	counterclaims, or claim for indemnity or contribution arising
127	from the claim maintained in contract or in tort pursuant to
128	common law, s. 400.023, or s. 400.0233. This subsection does not
129	abrogate a judgment debtor's obligation to satisfy the entire
130	amount of any judgment. Upon notification of the existence of an
131	unsatisfied judgment or payment pursuant to this subsection, the
132	agency shall notify the nursing home facility by certified mail
133	that its license shall be suspended unless, within 30 days from
134	the date of mailing, the facility either:
135	(a)  Shows proof that the unsatisfied judgment has been
136	paid in the amount specified in this subparagraph; or
137	(b)  Furnishes the department with a copy of a timely filed
138	notice of appeal and either:
139	1.  A copy of a supersedeas bond properly posted in the
140	amount required by law; or
141	2.  An order from a court of competent jurisdiction staying
142	execution on the final judgment pending disposition of the
143	appeal.
144	(c)  The agency shall issue an emergency order suspending
145	the license of any nursing home facility who, after 30 days
146	following receipt of a notice from the agency, has failed to:
147	1.  Satisfy a claim maintained in contract or in tort
148	pursuant to common law, s. 400.023, or s. 400.0233 against it in
149	accordance with subsection (6);
150	2. Furnish the agency with a copy of a timely filed notice
151	of appeal;
152	3.  Furnish the agency with a copy of a supersedeas bond
153	properly posted in the amount required by law; or
154	4.  Furnish the agency with an order from a court of
155	competent jurisdiction staying execution on the final judgment
156	pending disposition of the appeal.
157	(4)  Any deceptive, untrue, or fraudulent representation by
158	the nursing home facility with respect to any provision of this
159	section shall result in permanent disqualification from any
160	exemption to mandated financial responsibility as provided in
161	this section and the immediate suspension of the license of the
162	nursing home facility.
163	(5)  Any nursing home facility that is exempt from the
164	financial responsibility requirement shall notify the agency, in
165	writing, of any change of circumstance regarding its
166	qualifications for such exemption and shall demonstrate that it
167	is in compliance with the requirements of this section.
168	(6)  The agency shall adopt rules to implement this
169	section.
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174	T I T L E  A M E N D M E N T
175	Remove line 209 and insert:
176	entities; creating s. 400.1411, F.S.; requiring maintenance of
177	an escrow account, liability insurance coverage, or an
178	irrevocable letter of credit as a condition of licensure for
179	nursing home facilities; providing requirements and procedures
180	thereto; providing for payment of any outstanding judgments or
181	settlements pending at the time the license of a nursing home
182	facility is suspended by the Agency for Health Care
183	Administration; requiring the agency to adopt rules; providing
184	applicability; providing for

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