Florida Senate - 2011 COMMITTEE AMENDMENT Bill No. PCS (548162) for SB 1838 Barcode 324974 LEGISLATIVE ACTION Senate . House Comm: RCS . 04/13/2011 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Regulation (Bennett) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 88 - 218 4 and insert: 5 (e) Specify provisions to prohibit a quality improvement 6 team from contracting with an assisted living facility in a 7 manner that creates a conflict of interest. 8 (f) Create an enrollment process and implementation 9 timeline for the pilot project. 10 (g) Establish a process to notify residents and the local 11 long-term care ombudsman council of each assisted living 12 facility that is enrolled in the pilot project. 13 (h) Establish the components and provisions that must be 14 contained in a contract between the facility and the approved 15 quality improvement team. 16 (i) Establish the procedures for resolving complaints that 17 are filed against a facility that is enrolled in the pilot 18 project. 19 (5) The administrator of a licensed facility that is 20 eligible to participate in the pilot project shall notify the 21 agency when the facility agrees to enroll. Enrollment in the 22 pilot project is voluntary. The agency shall enroll the first 20 23 eligible facilities in each area that seek enrollment. Before 24 enrollment, each facility must execute a memorandum of agreement 25 with the agency which includes a provision authorizing the 26 agency to terminate the facility’s participation in the pilot 27 project at will. The agency’s termination of a facility from the 28 pilot project may not be challenged or appealed under chapter 29 120, Florida Statutes. 30 (6) Open enrollment in the pilot project shall span from 31 January 1 until March 1 of each year. A facility’s enrollment in 32 the pilot project does not prohibit the facility from seeking 33 alternative accreditation from a recognized health care 34 accreditation organization, such as the Commission on 35 Accreditation of Rehabilitative Facilities or The Joint 36 Commission. 37 (7) The owner or administrator of each facility enrolled in 38 the pilot project shall enter into a contract with an approved 39 quality improvement team to develop, in accordance with the 40 department’s rules, and implement a quality improvement plan for 41 that facility. The facility must pay the quality improvement 42 team reasonable compensation for the services provided under the 43 contract. The quality improvement plan must be approved by the 44 agency prior to any implementation of the plan. The owner or 45 administrator shall consult with the quality improvement team 46 for the purpose of meeting the goals outlined in the quality 47 improvement plan. 48 (8) Each quality improvement team must evaluate the 49 progress of the facility in meeting the goals of the quality 50 improvement plan. A quality improvement team shall include a 51 quality improvement specialist who has professional expertise or 52 a background in working with behavioral health needs or aging 53 related needs, a licensed registered nurse, a licensed 54 dietician, and a staff development representative. 55 (9) Each quality improvement team must be approved by the 56 agency prior to entering into any contract with a facility. The 57 agency may revoke the approval of the quality improvement team 58 if the quality improvement team does not meet the requirements 59 or standards established by department rule. If such approval is 60 revoked, the quality improvement team may no longer provide 61 contract services to the facility and the facility must, within 62 30 days, enter into a contract with another approved quality 63 improvement team in order to remain enrolled in the pilot 64 project. 65 (10) Each quality improvement team shall: 66 (a) Conduct an annual assessment and followup visits as 67 needed to monitor the progress of the facility in meeting the 68 goals of the quality improvement plan. 69 (b) Consult with the owner and administrator of the 70 facility in meeting plan requirements, create systems to monitor 71 compliance with agency rules, ensure that training standards 72 established under s. 429.52, Florida Statutes, are met, and 73 provide access to community-based services that would improve 74 the care of the residents and the conditions in the facility. 75 (c) Maintain records of the assessments and ongoing efforts 76 to help the facility meet quality improvement goals. 77 (d) Issue a certification to each facility that meets 78 agency standards and is in compliance with the goals of its 79 quality improvement plan. 80 (11) A quality improvement team may terminate, without 81 penalty, the contract executed under subsection (7) with a 82 facility that has failed to meet the goals of the plan after 83 reasonable efforts are made to seek cooperation and assistance 84 from the owner and the administrator of the facility. If a 85 contract is terminated under these conditions, the facility is 86 automatically terminated from the pilot project. 87 (12) If a facility’s enrollment in the pilot project is 88 terminated, the quality improvement team shall notify the agency 89 and that facility shall be subject to the survey, inspection, 90 and monitoring visits conducted under s. 408.811, Florida 91 Statutes. The facility is not eligible to reenroll in the pilot 92 project until the agency has certified that the facility is in 93 substantial compliance with agency rules. 94 (13) A facility that has entered into a contract with an 95 approved quality improvement team may terminate that contract 96 without penalty and enter into a contract with another approved 97 team. If such termination is sought, the facility administrator 98 shall notify the agency area office in writing and specify the 99 reasons the facility seeks to terminate the contract. The agency 100 shall approve or reject the request under the terms and 101 conditions of the memorandum of agreement completed by the 102 facility before enrolling in the pilot project. 103 (14) The agency shall refer any complaint concerning the 104 facility to the quality improvement team if the complaint does 105 not allege immediate jeopardy to a resident of the facility, 106 serious substandard care, or actual harm to a resident of the 107 facility. The team shall investigate the complaint and work with 108 the owner or administrator to address the complaint. If there is 109 a pattern of repeated complaints, the agency may investigate 110 those complaints and refer the complaints to the appropriate law 111 enforcement agency in the local jurisdiction for investigation 112 to ensure the health, safety, and well-being of the facility’s 113 residents. 114 (15) The agency may investigate and conduct periodic 115 appraisal visits at any time in order to ensure compliance with 116 Florida law and the approved quality improvement plan and assess 117 the quality improvement team and the facility. If the agency 118 finds that the facility is in substantial noncompliance with the 119 quality improvement plan or state law, the agency may terminate 120 the facility from the pilot project and shall require the 121 facility to be subject to the survey, inspection, and monitoring 122 visits conducted under s. 408.811, Florida Statutes. 123 (16)(a) Each quality improvement team shall make available 124 to the agency reports generated following a visit to an enrolled 125 facility. 126 (b) Each quality improvement team may use electronic means 127 of capturing data and generating reports relating to compliance 128 with the quality improvement plan. 129 (17) Reports and documents generated by the quality 130 improvement teams may not be used in any tort action sought 131 against the licenseholder of an enrolled facility. 132 (18) A facility owner, administrator, or employee may not 133 have an ownership interest in, or provide services to, any 134 business owned by a member of a quality improvement team, and an 135 owner, administrator, or employee may not participate as a 136 member of a quality improvement team. 137 138 ================= T I T L E A M E N D M E N T ================ 139 And the title is amended as follows: 140 Delete lines 31 - 51 141 and insert: 142 pilot project; authorizing a facility to terminate its 143 contract with a quality improvement team and execute a 144 contract with another team; requiring the agency to 145 approve or reject the request for another team; 146 requiring the agency to refer certain complaints 147 regarding a facility to the quality improvement team; 148 authorizing the agency to investigate repeated 149 complaints and refer them to the appropriate law 150 enforcement agency; authorizing the agency to 151 investigate and conduct periodic appraisal visits of a 152 facility; authorizing the agency to terminate a 153 facility from the pilot project and require that the 154 facility be subject to survey, inspection, and 155 monitoring visits by the agency; requiring each 156 quality improvement team to make available to the 157 agency certain reports; authorizing a quality 158 improvement team to use electronic means of capturing 159 data and generating reports; providing that reports 160 and documents of the quality improvement team may not 161 be used in certain tort actions; providing an 162 effective date.