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
    1         Senate Amendment (with title amendment)
    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.
  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.