Florida Senate - 2012 COMMITTEE AMENDMENT
Bill No. CS for SB 2074
Barcode 243514
LEGISLATIVE ACTION
Senate . House
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The Committee on Budget Subcommittee on Health and Human
Services Appropriations (Garcia) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Section 394.4574, Florida Statutes, is amended
6 to read:
7 394.4574 Department responsibilities for a mental health
8 resident who resides in an assisted living facility that holds a
9 limited mental health license.—
10 (1) The term “mental health resident,” for purposes of this
11 section, means an individual who receives social security
12 disability income due to a mental disorder as determined by the
13 Social Security Administration or receives supplemental security
14 income due to a mental disorder as determined by the Social
15 Security Administration and receives optional state
16 supplementation.
17 (2) The department must ensure that:
18 (a) A mental health resident has been assessed by a
19 psychiatrist, clinical psychologist, clinical social worker, or
20 psychiatric nurse, or an individual who is supervised by one of
21 these professionals, and determined to be appropriate to reside
22 in an assisted living facility. The documentation must be
23 provided to the administrator of the facility within 30 days
24 after the mental health resident has been admitted to the
25 facility. An evaluation completed upon discharge from a state
26 mental hospital meets the requirements of this subsection
27 related to appropriateness for placement as a mental health
28 resident if it was completed within 90 days prior to admission
29 to the facility.
30 (b) A cooperative agreement, as required in s. 429.075, is
31 developed between the mental health care services provider that
32 serves a mental health resident and the administrator of the
33 assisted living facility with a limited mental health license in
34 which the mental health resident is living. The cooperative
35 agreement must provide detailed information concerning case
36 management services; access to consumer-operated drop-in
37 centers; reliable access to services during evenings, weekends,
38 and holidays which avoids the use of hospital emergency
39 departments except in emergencies; supervision of clinical needs
40 of the residents; and access to emergency psychiatric care. Any
41 entity that provides Medicaid prepaid health plan services shall
42 ensure the appropriate coordination of health care services with
43 an assisted living facility in cases where a Medicaid recipient
44 is both a member of the entity’s prepaid health plan and a
45 resident of the assisted living facility. If the entity is at
46 risk for Medicaid targeted case management and behavioral health
47 services, the entity shall inform the assisted living facility
48 of the procedures to follow should an emergent condition arise.
49 (c) The community living support plan, as defined in s.
50 429.02, has been prepared by a mental health resident and a
51 mental health case manager of that resident in consultation with
52 the administrator of the facility or the administrator’s
53 designee. The plan must be provided to the administrator of the
54 assisted living facility with a limited mental health license in
55 which the mental health resident lives. The support plan and the
56 agreement may be in one document.
57 (d) The assisted living facility with a limited mental
58 health license is provided with documentation that the
59 individual meets the definition of a mental health resident.
60 (e) The mental health services provider assigns a case
61 manager to each mental health resident who lives in an assisted
62 living facility with a limited mental health license. The case
63 manager is responsible for coordinating the development of and
64 implementation of the community living support plan defined in
65 s. 429.02. The plan must be updated as needed, but at least
66 annually to ensure that the ongoing needs of the resident are
67 addressed. The community living support plan must include a
68 detailed description of how the clinical needs of the resident
69 will be supervised, how often the case manager will see the
70 resident, and how the resident may access the case manager, and
71 must identify conditions indicative of a change in the condition
72 of the resident which might warrant changes in clinical
73 supervision or which might prompt the assisted living facility
74 to contact the case manager on behalf of the resident and the
75 steps that will be taken to ensure that the resident receives
76 appropriate emergency psychiatric care through the mental health
77 provider. Each case manager shall keep a record of the date and
78 time of any face-to-face interaction with the mental health
79 resident and make the record available to the department for
80 inspection. The record must be retained for 2 years after the
81 date of the most recent interaction.
82 (f) There is adequate and consistent monitoring and
83 enforcement of community living support plans and cooperative
84 agreements by the department.
85 (3) Medicaid prepaid health plans shall ensure the
86 appropriate coordination of health care services with an
87 assisted living facility when a Medicaid recipient is both a
88 member of the entity’s prepaid health plan and a resident of the
89 assisted living facility. If the Medicaid prepaid plan is
90 responsible for Medicaid targeted case management and behavioral
91 health services, the plan shall inform the assisted living
92 facility of the procedures to follow should an emergency
93 condition arise.
94 (4) The department shall include in contracts with service
95 providers provisions that require the service provider to assign
96 a case manager for a mental health resident, prepare a community
97 living support plan, enter into a cooperative agreement with the
98 assisted living facility, and otherwise comply with this
99 section. The department shall establish and impose penalties for
100 mental health service providers under contract with the
101 department which fail to comply with the provisions of this
102 section.
103 (5) The Agency for Health Care Administration shall
104 establish and impose contract penalties for Medicaid prepaid
105 plans that fail to comply with the provisions of this section.
106 (6) The department shall enter into an interagency
107 agreement with the Agency for Health Care Administration which
108 delineates responsibilities and procedures for enforcing the
109 provisions of this section related to the requirements of
110 facilities and mental health providers.
111 (7)(3) The Secretary of Children and Family Services, in
112 consultation with the Agency for Health Care Administration,
113 shall annually require each district administrator to develop,
114 with community input, detailed plans that demonstrate how the
115 district will ensure the provision of state-funded mental health
116 and substance abuse treatment services to residents of assisted
117 living facilities that hold a limited mental health license.
118 These plans must be consistent with the substance abuse and
119 mental health district plan developed pursuant to s. 394.75 and
120 must address case management services; access to consumer
121 operated drop-in centers; access to services during evenings,
122 weekends, and holidays; supervision of the clinical needs of the
123 residents; and access to emergency psychiatric care.
124 Section 2. Subsection (2) of section 400.0078, Florida
125 Statutes, is amended to read:
126 400.0078 Citizen access to State Long-Term Care Ombudsman
127 Program services.—
128 (2) Every resident or representative of a resident shall
129 receive, Upon admission to a long-term care facility, each
130 resident or representative of a resident must receive
131 information regarding the purpose of the State Long-Term Care
132 Ombudsman Program, the statewide toll-free telephone number for
133 receiving complaints, the confidentiality of a complaint if the
134 complaint will result in the identification of the resident
135 about whom the complaint is made and the confidentiality of the
136 complainant’s name and identity, and other relevant information
137 regarding how to contact the program. Residents or their
138 representatives must be furnished additional copies of this
139 information upon request.
140 Section 3. Paragraph (a) of subsection (1) of section
141 415.1034, Florida Statutes, is amended to read:
142 415.1034 Mandatory reporting of abuse, neglect, or
143 exploitation of vulnerable adults; mandatory reports of death.—
144 (1) MANDATORY REPORTING.—
145 (a) Any person, including, but not limited to, any:
146 1. A physician, osteopathic physician, medical examiner,
147 chiropractic physician, nurse, paramedic, emergency medical
148 technician, or hospital personnel engaged in the admission,
149 examination, care, or treatment of vulnerable adults;
150 2. A health professional or mental health professional
151 other than one listed in subparagraph 1.;
152 3. A practitioner who relies solely on spiritual means for
153 healing;
154 4. Nursing home staff; assisted living facility staff;
155 adult day care center staff; adult family-care home staff;
156 social worker; or other professional adult care, residential, or
157 institutional staff;
158 5. A state, county, or municipal criminal justice employee
159 or law enforcement officer;
160 6. An employee of the Department of Business and
161 Professional Regulation conducting inspections of public lodging
162 establishments under s. 509.032;
163 7. A Florida advocacy council member or long-term care
164 ombudsman council member; or
165 8. A bank, savings and loan, or credit union officer,
166 trustee, or employee; or,
167 9. An employee or agent of a state or local agency who has
168 regulatory responsibilities over state-licensed facilities, or
169 who provides services to persons residing in a state-licensed
170 facility,
171
172 who knows, or has reasonable cause to suspect, that a vulnerable
173 adult has been or is being abused, neglected, or exploited must
174 shall immediately report such knowledge or suspicion to the
175 central abuse hotline.
176 Section 4. Subsections (5) and (11) of section 429.02,
177 Florida Statutes, are amended, present subsections (6) through
178 (14) of that section are redesignated as subsections (7) through
179 (15), respectively, present subsections (15) through (26) of
180 that section are redesignated as subsections (17) through (28),
181 respectively, and new subsections (6) and (16) are added to that
182 section, to read:
183 429.02 Definitions.—When used in this part, the term:
184 (5) “Assisted living facility” or “facility” means any
185 building or buildings, section or distinct part of a building,
186 private home, boarding home, home for the aged, or other
187 residential facility, whether operated for profit or not, which
188 undertakes through its ownership or management to provide
189 housing, meals, and one or more personal services for a period
190 exceeding 24 hours to one or more adults who are not relatives
191 of the owner or administrator.
192 (6) “Board” means the Board of Long Term Care
193 Administrators established under s. 468.1665.
194 (12)(11) “Extended congregate care” means acts beyond those
195 authorized in subsection (18) which subsection (16) that may be
196 performed pursuant to part I of chapter 464 by persons licensed
197 thereunder while carrying out their professional duties, and
198 other supportive services which may be specified by rule. The
199 purpose of such services is to enable residents to age in place
200 in a residential environment despite mental or physical
201 limitations that might otherwise disqualify them from residency
202 in a facility licensed under this part.
203 (16) “Mental health surveyor” means a person:
204 (a) Licensed under chapter 458, chapter 459, chapter 464,
205 chapter 490, or chapter 491 who provides mental health services
206 as defined under s. 394.67 or has received training approved by
207 the agency;
208 (b) Who has a baccalaureate degree with a concentration in
209 mental health from an accredited college or university and at
210 least 5 years of experience providing services that improve an
211 individual’s mental health or that treat mental illness; or
212 (c) Who has a baccalaureate degree and who has received
213 training approved by the agency that enables the individual to
214 effectively perform surveys of facilities with a limited mental
215 health license to ensure the mental health residents are
216 receiving services consistent with the community living support
217 plan.
218 Section 5. Paragraphs (b) and (c) of subsection (3) of
219 section 429.07, Florida Statutes, are amended, and paragraph (d)
220 is added to subsection (4) of that section, to read:
221 429.07 License required; fee.—
222 (3) In addition to the requirements of s. 408.806, each
223 license granted by the agency must state the type of care for
224 which the license is granted. Licenses shall be issued for one
225 or more of the following categories of care: standard, extended
226 congregate care, limited nursing services, or limited mental
227 health.
228 (b) An extended congregate care license shall be issued to
229 facilities providing, directly or through contract, services
230 beyond those authorized in paragraph (a), including services
231 performed by persons licensed under part I of chapter 464 and
232 supportive services, as defined by rule, to persons who would
233 otherwise be disqualified from continued residence in a facility
234 licensed under this part.
235 1. In order for extended congregate care services to be
236 provided, the agency must first determine that all requirements
237 established in law and rule are met and must specifically
238 designate, on the facility’s license, that such services may be
239 provided and whether the designation applies to all or part of
240 the facility. Such designation may be made at the time of
241 initial licensure or relicensure, or upon request in writing by
242 a licensee under this part and part II of chapter 408. The
243 notification of approval or the denial of the request shall be
244 made in accordance with part II of chapter 408. Existing
245 facilities qualifying to provide extended congregate care
246 services must have maintained a standard license and may not
247 have been subject to administrative sanctions during the
248 previous 2 years, or since initial licensure if the facility has
249 been licensed for less than 2 years, for any of the following
250 reasons:
251 a. A class I or class II violation;
252 b. Three or more repeat or recurring class III violations
253 of identical or similar resident care standards from which a
254 pattern of noncompliance is found by the agency;
255 c. Three or more class III violations that were not
256 corrected in accordance with the corrective action plan approved
257 by the agency;
258 d. Violation of resident care standards which results in
259 requiring the facility to employ the services of a consultant
260 pharmacist or consultant dietitian;
261 e. Denial, suspension, or revocation of a license for
262 another facility licensed under this part in which the applicant
263 for an extended congregate care license has at least 25 percent
264 ownership interest; or
265 f. Imposition of a moratorium pursuant to this part or part
266 II of chapter 408 or initiation of injunctive proceedings.
267 2. A facility that is licensed to provide extended
268 congregate care services must shall maintain a written progress
269 report on each person who receives services which describes the
270 type, amount, duration, scope, and outcome of services that are
271 rendered and the general status of the resident’s health. A
272 registered nurse, or appropriate designee, representing the
273 agency shall visit the facility at least quarterly to monitor
274 residents who are receiving extended congregate care services
275 and to determine if the facility is in compliance with this
276 part, part II of chapter 408, and relevant rules. One of the
277 visits may be in conjunction with the regular survey. The
278 monitoring visits may be provided through contractual
279 arrangements with appropriate community agencies. A registered
280 nurse shall serve as part of the team that inspects the
281 facility. The agency may waive a monitoring visit during the
282 licensure cycle one of the required yearly monitoring visits for
283 a facility that has been licensed for at least 24 months to
284 provide extended congregate care services, if, during the
285 inspection, the registered nurse determines that extended
286 congregate care services are being provided appropriately, and
287 if the facility:
288 a. Has no class I or class II violations and no uncorrected
289 class III violations;.
290 b. Has no ombudsman referrals that were made to the agency
291 which resulted in a citation for a licensure violation; and
292 c. Has no complaints that resulted in citation for a
293 licensure violation. The agency must first consult with the
294 long-term care ombudsman council for the area in which the
295 facility is located to determine if any complaints have been
296 made and substantiated about the quality of services or care.
297 The agency may not waive one of the required yearly monitoring
298 visits if complaints have been made and substantiated.
299 3. A facility that is licensed to provide extended
300 congregate care services must:
301 a. Demonstrate the capability to meet unanticipated
302 resident service needs.
303 b. Offer a physical environment that promotes a homelike
304 setting, provides for resident privacy, promotes resident
305 independence, and allows sufficient congregate space as defined
306 by rule.
307 c. Have sufficient staff available, taking into account the
308 physical plant and firesafety features of the building, to
309 assist with the evacuation of residents in an emergency.
310 d. Adopt and follow policies and procedures that maximize
311 resident independence, dignity, choice, and decisionmaking to
312 permit residents to age in place, so that moves due to changes
313 in functional status are minimized or avoided.
314 e. Allow residents or, if applicable, a resident’s
315 representative, designee, surrogate, guardian, or attorney in
316 fact to make a variety of personal choices, participate in
317 developing service plans, and share responsibility in
318 decisionmaking.
319 f. Implement the concept of managed risk.
320 g. Provide, directly or through contract, the services of a
321 person licensed under part I of chapter 464.
322 h. In addition to the training mandated in s. 429.52,
323 provide specialized training as defined by rule for facility
324 staff.
325 4. A facility that is licensed to provide extended
326 congregate care services is exempt from the criteria for
327 continued residency set forth in rules adopted under s. 429.41.
328 A licensed facility must adopt its own requirements within
329 guidelines for continued residency set forth by rule. However,
330 the facility may not serve residents who require 24-hour nursing
331 supervision. A licensed facility that provides extended
332 congregate care services must also provide each resident with a
333 written copy of facility policies governing admission and
334 retention.
335 5. The primary purpose of extended congregate care services
336 is to allow residents, as they become more impaired, the option
337 of remaining in a familiar setting from which they would
338 otherwise be disqualified for continued residency. A facility
339 licensed to provide extended congregate care services may also
340 admit an individual who exceeds the admission criteria for a
341 facility with a standard license, if the individual is
342 determined appropriate for admission to the extended congregate
343 care facility.
344 6. Before the admission of an individual to a facility
345 licensed to provide extended congregate care services, the
346 individual must undergo a medical examination as provided in s.
347 429.26(4) and the facility must develop a preliminary service
348 plan for the individual.
349 7. If When a facility can no longer provide or arrange for
350 services in accordance with the resident’s service plan and
351 needs and the facility’s policy, the facility must shall make
352 arrangements for relocating the person in accordance with s.
353 429.28(1)(k).
354 8. Failure to provide extended congregate care services may
355 result in denial of extended congregate care license renewal.
356 (c) A limited nursing services license shall be issued to a
357 facility that provides services beyond those authorized in
358 paragraph (a) and as specified in this paragraph.
359 1. In order for limited nursing services to be provided in
360 a facility licensed under this part, the agency must first
361 determine that all requirements established in law and rule are
362 met and must specifically designate, on the facility’s license,
363 that such services may be provided. Such designation may be made
364 at the time of initial licensure or relicensure, or upon request
365 in writing by a licensee under this part and part II of chapter
366 408. Notification of approval or denial of such request shall be
367 made in accordance with part II of chapter 408. Existing
368 facilities qualifying to provide limited nursing services shall
369 have maintained a standard license and may not have been subject
370 to administrative sanctions that affect the health, safety, and
371 welfare of residents for the previous 2 years or since initial
372 licensure if the facility has been licensed for less than 2
373 years.
374 2. Facilities that are licensed to provide limited nursing
375 services shall maintain a written progress report on each person
376 who receives such nursing services, which report describes the
377 type, amount, duration, scope, and outcome of services that are
378 rendered and the general status of the resident’s health. A
379 registered nurse representing the agency shall visit such
380 facilities at least twice a year to monitor residents who are
381 receiving limited nursing services and to determine if the
382 facility is in compliance with applicable provisions of this
383 part, part II of chapter 408, and related rules. The monitoring
384 visits may be provided through contractual arrangements with
385 appropriate community agencies. A registered nurse shall also
386 serve as part of the team that inspects such facility. The
387 agency may waive a monitoring visit during the licensure cycle
388 for a facility that has been licensed for at least 24 months to
389 provide limited nursing services if the facility:
390 a. Has no class I or class II violations and no uncorrected
391 class III violations;
392 b. Has no ombudsman referrals that were made to the agency
393 which resulted in a citation for a licensure violation; and
394 c. Has no complaints which resulted in citation for a
395 licensure violation.
396 3. A person who receives limited nursing services under
397 this part must meet the admission criteria established by the
398 agency for assisted living facilities. When a resident no longer
399 meets the admission criteria for a facility licensed under this
400 part, arrangements for relocating the person shall be made in
401 accordance with s. 429.28(1)(k), unless the facility is licensed
402 to provide extended congregate care services.
403 (4) In accordance with s. 408.805, an applicant or licensee
404 shall pay a fee for each license application submitted under
405 this part, part II of chapter 408, and applicable rules. The
406 amount of the fee shall be established by rule.
407 (d) A licensed facility that has one or more class I or
408 class II violations imposed by final order within the 2 years
409 before licensure renewal is required to pay an additional $500
410 license fee plus an additional fee of $55 for each licensed bed,
411 without exception. The increased fee amounts are subject to
412 annual adjustment pursuant to s. 408.805.
413 Section 6. Section 429.075, Florida Statutes, is amended to
414 read:
415 429.075 Limited mental health license.—An assisted living
416 facility that serves three or more mental health residents must
417 obtain a limited mental health license.
418 (1) To obtain a limited mental health license, a facility
419 must hold and maintain a standard license as an assisted living
420 facility and, must not have been subject to administrative
421 sanctions during the previous 2 years, or since initial
422 licensure if the facility has been licensed for less than 2
423 years, for any of the following reasons:
424 (a) Two or more class I or class II violations;
425 (b) Three or more repeat or recurring class III violations
426 of resident care standards from which a pattern of noncompliance
427 is found by the agency;
428 (c) Three or more class III violations that were not
429 corrected in accordance within the time specified by the agency
430 for correction;
431 (d) Denial, suspension, or revocation of a license for
432 another facility licensed under this part in which the applicant
433 had at least a 25 percent ownership interest; or
434 (f) Imposition of a moratorium pursuant to this part or
435 part II of chapter 408 or initiation of injunctive proceedings.
436 any current uncorrected deficiencies or violations, and must
437 ensure that, within 6 months after receiving a limited mental
438 health license, the facility administrator and the staff of the
439 facility who are in direct contact with mental health residents
440 must complete training of no less than 6 hours related to their
441 duties. Such designation
442 (2) Licensure to provide services to mental health
443 residents may be made at the time of initial licensure or
444 relicensure or upon request in writing by a licensee under this
445 part and part II of chapter 408. Notification of agency approval
446 or denial of such request must shall be made in accordance with
447 this part, part II of chapter 408, and applicable rules. This
448 training will be provided by or approved by the Department of
449 Children and Family Services.
450 (3)(2) Facilities licensed to provide services to mental
451 health residents shall provide appropriate supervision and
452 staffing to provide for the health, safety, and welfare of such
453 residents. In addition to the general training or educational
454 requirements under this part or part II of chapter 468, as
455 applicable, each administrator and staff member who provides
456 regular or direct care to the residents of a facility licensed
457 to provide services to mental health residents must meet the
458 specialized limited mental health training requirements set
459 forth in s. 429.52.
460 (4)(3) A facility that holds has a limited mental health
461 license must:
462 (a) Have a copy of each mental health resident’s community
463 living support plan and the cooperative agreement with the
464 mental health care services provider. The support plan and the
465 agreement may be combined.
466 (b) Have documentation that is provided by the Department
467 of Children and Family Services that each mental health resident
468 has been assessed and determined to be able to live in the
469 community in an assisted living facility with a limited mental
470 health license.
471 (c) Make the community living support plan available for
472 inspection by the resident, the resident’s legal guardian, the
473 resident’s health care surrogate, and other individuals who have
474 a lawful basis for reviewing this document.
475 (d) Assist the mental health resident in carrying out the
476 activities identified in the individual’s community living
477 support plan.
478 (5)(4) A facility that holds with a limited mental health
479 license may enter into a cooperative agreement with a private
480 mental health provider. For purposes of the limited mental
481 health license, the private mental health provider may act as
482 the case manager.
483 (6) Effective January 1, 2013, a mental health surveyor
484 shall serve as part of the team that inspects a facility that
485 holds a limited mental health license, and may conduct the
486 inspection without other agency representatives. The role of the
487 mental health surveyor is to determine the facility’s compliance
488 in meeting obligations specified in the cooperative agreement
489 pursuant to s. 394.4574. The agency shall enter into an
490 interagency agreement with the Department of Children and Family
491 Services to receive from the contracted community agencies
492 reports concerning compliance with the requirements of
493 cooperative agreements and community support plans under s.
494 394.4574 applicable to a licensed facility, and whether the
495 mental health residents are receiving the services required
496 under those documents while residing in the licensed facility.
497 Monitoring visits shall occur at least twice a year. The agency
498 may waive a monitoring visit for a facility that has been
499 licensed for at least 24 months to provide limited mental health
500 services if the mental health surveyor determines the
501 cooperative agreements and community support plans are in
502 compliance with applicable requirements and the mental health
503 residents are receiving the appropriate services under those
504 documents while residing in the licensed facility and the
505 facility:
506 (a) Has had no class I or class II violations and no
507 uncorrected class III violations;
508 (b) Has no ombudsman referrals that were made to the agency
509 which resulted in a citation for a licensure violation; and
510 (c) Has no complaints that resulted in a citation for a
511 licensure violation.
512 Section 7. Subsection (4) of section 429.14, Florida
513 Statutes, is amended to read:
514 429.14 Administrative penalties.—
515 (4) The agency shall deny or revoke the license of an
516 assisted living facility that:
517 (a) Has two or more class I violations and had a class I or
518 class II violation from separate monitoring visits, surveys, or
519 investigations that are similar or identical to violations
520 identified by the agency during a survey, inspection, monitoring
521 visit, or complaint investigation occurring within the previous
522 2 years; or.
523 (b) Commits a class I violation that causes the death of a
524 resident or an intentional or negligent act that, based on a
525 court’s findings, caused the death of a resident.
526 Section 8. Section 429.176, Florida Statutes, is amended to
527 read:
528 429.176 Notice of change of Administrator; managers.—
529 (1) Effective July 1, 2013, an assisted living facility
530 must have an assisted living facility administrator who is
531 licensed under part II of chapter 468. An administrator may be
532 responsible for up to three assisted living facilities if all
533 three assisted living facilities have identical controlling
534 interests as defined in s. 408.803 and are located within 50
535 miles of each other. If an administrator is responsible for more
536 than one assisted living facility, a manager must be appointed
537 for each facility to assume responsibility for the facility
538 during the administrator’s absence. The manager must be reported
539 to the agency within 10 days after appointment.
540 (2) If, during the period for which a license is issued,
541 the owner changes administrators, the administrator changes, the
542 licensee owner must notify the agency of the change and the name
543 and license number of the new administrator within 10 days after
544 the change and provide documentation within 90 days that the new
545 administrator has completed the applicable core educational
546 requirements under s. 429.52.
547 (3) If an administrator leaves the employment of an
548 assisted living facility, and a licensed administrator is not
549 named as required in subsection (2), the assisted living
550 facility must notify the agency within 2 days after the
551 administrator’s departure and may operate for up to 3 months
552 with a manager who will assume responsibility for the operation
553 of the facility during that period. The manager must have
554 completed the 40-hour core training and successfully passed the
555 examination described in s. 429.52(5).
556 (4) A manager of a facility who assumes responsibility for
557 the operation of the facility during the absence of an
558 administrator in accordance with subsection (1) must have
559 completed the 40-hour core training and successfully passed the
560 examination described in s. 429.52(5) within 30 days after being
561 employed as, or becoming, a facility manager.
562 Section 9. Paragraphs (a) and (b) of subsection (2) of
563 section 429.178, Florida Statutes, are amended to read:
564 429.178 Special care for persons with Alzheimer’s disease
565 or other related disorders.—
566 (2)(a) Staff, including administrators, An individual who
567 are is employed by a facility that provides special care for
568 residents who have with Alzheimer’s disease or other related
569 disorders, and who provide has regular or direct care to contact
570 with such residents, must complete up to 4 hours of initial
571 dementia-specific training developed or approved by the
572 department. The training must shall be completed within 3 months
573 after beginning employment and shall satisfy the core training
574 requirements of s. 429.52(2)(g).
575 (b) A direct caregiver who is employed by a facility that
576 provides special care for residents with Alzheimer’s disease or
577 other related disorders, and who provides direct care to such
578 residents, must complete the required initial training required
579 in paragraph (a) and 4 additional hours of training developed or
580 approved by the department. The training must shall be completed
581 within 6 9 months after beginning employment and shall satisfy
582 the core training requirements of s. 429.52(2)(g).
583 Section 10. Subsection (2) of section 429.19, Florida
584 Statutes, is amended to read:
585 429.19 Violations; imposition of administrative fines;
586 grounds.—
587 (2) Each violation of this part and adopted rules shall be
588 classified according to the nature of the violation and the
589 gravity of its probable effect on facility residents as provided
590 in s. 408.813.
591 (a) The agency shall indicate the classification on the
592 written notice of the violation as follows:
593 1.(a) For class “I” violations, are defined in s. 408.813.
594 the agency shall issue a citation regardless of correction and
595 impose an administrative fine for a cited class I violation in
596 an amount not less than $5,000 and not exceeding $10,000 for
597 each violation.
598 2.(b) For class “II” violations, are defined in s. 408.813.
599 the agency shall issue a citation regardless of correction and
600 impose an administrative fine for a cited class II violation in
601 an amount not less than $1,000 and not exceeding $5,000 for each
602 violation.
603 3.(c) For class “III” violations, are defined in s.
604 408.813. the agency shall impose an administrative fine for a
605 cited class III violation in an amount not less than $500 and
606 not exceeding $1,000 for each violation.
607 4.(d) For class “IV” violations, are defined in s. 408.813.
608 the agency shall impose an administrative fine for a cited class
609 IV violation in an amount not less than $100 and not exceeding
610 $200 for each violation.
611 (b) The agency shall impose the maximum penalty within the
612 class if the violation findings involve the death of a resident.
613 If the facility is cited for a repeat violation within a 2-year
614 period, the agency shall double the fine for the second and
615 subsequent violation even if the fine exceeds the maximum amount
616 authorized. Notwithstanding s. 408.813, if a facility is cited
617 for 15 or more class III violations during an inspection or
618 survey, the agency shall impose a fine for each violation.
619 Section 11. Section 429.231, Florida Statutes, is created
620 to read:
621 429.231 Advisory council, membership, duties.—
622 (1) The department shall establish an advisory council to
623 review the facts and circumstances of unexpected deaths in
624 assisted living facilities and of elopements that result in harm
625 to a resident. The purpose of this review is to:
626 (a) Achieve a greater understanding of the causes and
627 contributing factors of the unexpected deaths and elopements.
628 (b) Identify any gaps, deficiencies, or problems in the
629 delivery of services to the residents.
630 (2) Based on the review, the advisory council shall make
631 recommendations for:
632 (a) Industry best practices that could be used to prevent
633 unexpected deaths and elopements.
634 (b) Training and educational requirements for employees and
635 administrators of assisted living facilities.
636 (c) Changes in the law, rules, or other policies to prevent
637 unexpected deaths and elopements.
638 (3) The advisory council shall prepare an annual
639 statistical report on the incidence and causes of unexpected
640 deaths in assisted living facilities and of elopements that
641 result in harm to residents during the prior calendar year. The
642 advisory council shall submit a copy of the report by December
643 31 of each year to the Governor, the President of the Senate,
644 and the Speaker of the House of Representatives. The report may
645 make recommendations for state action, including specific
646 policy, procedural, regulatory, or statutory changes, and any
647 other recommended preventive action.
648 (4) The advisory council shall consist of the following
649 members:
650 (a) The Secretary of Elderly Affairs, or a designee, who
651 shall be the chair.
652 (b) The Secretary of Health Care Administration, or a
653 designee.
654 (c) The Secretary of Children and Family Services, or a
655 designee.
656 (d) The State Long-Term Care Ombudsman, or a designee.
657 (e) The following persons who are selected by the Governor:
658 1. An owner or administrator of an assisted living facility
659 with fewer than 17 beds.
660 2. An owner or administrator of an assisted living facility
661 with 17 or more beds.
662 3. An owner or administrator or an assisted living facility
663 with a limited mental health license.
664 4. A representative from each of three statewide
665 associations that represent assisted living facilities.
666 5. A resident of an assisted living facility.
667 (5) The advisory council shall meet at least twice each
668 calendar year or at the call of the chair. The chair may appoint
669 ad hoc committees as necessary to carry out the duties of the
670 council.
671 (6) The members of the advisory council selected by the
672 Governor shall be appointed to staggered terms of office which
673 may not exceed 2 years. Members are eligible for reappointment.
674 (7) Members of the advisory council shall serve without
675 compensation but are entitled to reimbursement for per diem and
676 travel expenses incurred in the performance of their duties as
677 provided in s. 112.061 and to the extent that funds are
678 available.
679 Section 12. Effective October 1, 2012, subsections (1) and
680 (2), paragraph (d) of subsection (3), and subsection (6) of
681 section 429.28, Florida Statutes, are amended to read:
682 429.28 Resident bill of rights.—
683 (1) A No resident of a facility may not shall be deprived
684 of any civil or legal rights, benefits, or privileges guaranteed
685 by law, the Constitution of the State of Florida, or the
686 Constitution of the United States as a resident of a facility.
687 Every resident of a facility shall have the right to:
688 (a) Live in a safe and decent living environment, free from
689 abuse and neglect.
690 (b) Be treated with consideration and respect and with due
691 recognition of personal dignity, individuality, and the need for
692 privacy.
693 (c) Retain and use his or her own clothes and other
694 personal property in his or her immediate living quarters, so as
695 to maintain individuality and personal dignity, except when the
696 facility can demonstrate that such would be unsafe, impractical,
697 or an infringement upon the rights of other residents.
698 (d) Unrestricted private communication, including receiving
699 and sending unopened correspondence, access to a telephone, and
700 visiting with any person of his or her choice, at any time
701 between the hours of 9 a.m. and 9 p.m. at a minimum. Upon
702 request, the facility shall make provisions to extend visiting
703 hours for caregivers and out-of-town guests, and in other
704 similar situations.
705 (e) Freedom to participate in and benefit from community
706 services and activities and to achieve the highest possible
707 level of independence, autonomy, and interaction within the
708 community.
709 (f) Manage his or her financial affairs unless the resident
710 or, if applicable, the resident’s representative, designee,
711 surrogate, guardian, or attorney in fact authorizes the
712 administrator of the facility to provide safekeeping for funds
713 as provided in s. 429.27.
714 (g) Share a room with his or her spouse if both are
715 residents of the facility.
716 (h) Reasonable opportunity for regular exercise several
717 times a week and to be outdoors at regular and frequent
718 intervals except when prevented by inclement weather.
719 (i) Exercise civil and religious liberties, including the
720 right to independent personal decisions. No religious beliefs or
721 practices, nor any attendance at religious services, shall be
722 imposed upon any resident.
723 (j) Access to adequate and appropriate health care
724 consistent with established and recognized standards within the
725 community.
726 (k) At least 30 45 days’ notice of relocation or
727 termination of residency from the facility unless, for medical
728 reasons, the resident is certified by a physician to require an
729 emergency relocation to a facility providing a more skilled
730 level of care or the resident engages in a pattern of conduct
731 that is harmful or offensive to other residents. In the case of
732 a resident who has been adjudicated mentally incapacitated, the
733 guardian shall be given at least 30 45 days’ notice of a
734 nonemergency relocation or residency termination. Reasons for
735 relocation shall be set forth in writing. A resident or the
736 resident’s legal guardian or representative may file a grievance
737 with the facility pursuant to s. 429.281 in response to
738 receiving a notice of relocation or termination of residency
739 from the facility. If a grievance is filed, the effective date
740 of the relocation or termination or residency is extended at
741 least 15 days. In order for a facility to terminate the
742 residency of an individual without notice as provided herein,
743 the facility shall show good cause in a court of competent
744 jurisdiction.
745 (l) Present grievances and recommend changes in policies,
746 procedures, and services to the staff of the facility, governing
747 officials, or any other person without restraint, interference,
748 coercion, discrimination, or reprisal. Each facility shall
749 establish a grievance procedure to facilitate the residents’
750 exercise of this right. This right includes access to ombudsman
751 volunteers and advocates and the right to be a member of, to be
752 active in, and to associate with advocacy or special interest
753 groups.
754 (2) The administrator of a facility shall ensure that a
755 written notice of the rights, obligations, and prohibitions set
756 forth in this part is posted in a prominent place in each
757 facility and read or explained to residents who cannot read. The
758 This notice must shall include the name, address, and telephone
759 numbers of the local ombudsman council and central abuse hotline
760 and, if when applicable, Disability Rights Florida the Advocacy
761 Center for Persons with Disabilities, Inc., and the Florida
762 local advocacy council, where complaints may be lodged. The
763 notice must state that the names or identities of the
764 complainants or residents involved in a complaint made to the
765 Office of State Long-Term Care Ombudsman or a local long-term
766 care ombudsman council are confidential pursuant to s. 400.0077.
767 The facility must ensure a resident’s access to a telephone to
768 call the local ombudsman council, central abuse hotline,
769 Advocacy Center for Persons with Disabilities, Inc., and the
770 Florida local advocacy council.
771 (3)
772 (d) The agency shall conduct periodic followup inspections
773 to monitor the compliance of facilities having a history of
774 class I violations that threaten the health, safety, or security
775 of residents, and may conduct periodic followup inspections as
776 necessary to monitor the compliance of facilities having with a
777 history of any class I, class II, or class III violations that
778 threaten the health, safety, or security of residents.
779 (6) A Any facility that which terminates the residency of
780 an individual who participated in activities specified in
781 subsection (5) must shall show good cause in a court of
782 competent jurisdiction. If good cause is not shown, the agency
783 shall impose a fine of $2,500 in addition to any other penalty
784 assessed against the facility.
785 Section 13. Effective October 1, 2012, section 429.281,
786 Florida Statutes, is created to read:
787 429.281 Grievances for resident relocation or termination
788 of residency.—
789 (1) As used in this section, the term:
790 (a) “Relocation” means to move a resident from one facility
791 to another facility that is responsible for the resident’s care.
792 (b) “Termination of residency” means the release of a
793 resident from a facility that ceases to be responsible for the
794 resident’s care.
795 (2) Each facility licensed under this part must comply with
796 s. 429.28(1)(k) when a decision is made to relocate or terminate
797 the residency of a resident.
798 (3) Except as provided in s. 429.28(1)(k), at least 30 days
799 before a proposed relocation or termination of residency, the
800 facility must provide advance notice of the proposed relocation
801 or termination of residency to the resident and to a family
802 member, if known, or the resident’s legal guardian or
803 representative.
804 (4) The notice must be in writing and contain at a minimum,
805 the following:
806 (a) The date on which the notice is provided to the
807 resident or resident’s legal guardian or representative;
808 (b) The effective date of the relocation or termination of
809 residency if the resident:
810 1. Does not file a grievance; and
811 2. Files a grievance, which may not be less than 15 days
812 after the effective date if a grievance is not filed;
813 (c) Information about the facility’s procedures for filing
814 a grievance which is presented in a concise, straightforward
815 manner and is written at an eighth-grade reading level;
816 (d) Information about how to seek assistance from the local
817 long-term care ombudsman council for a grievance;
818 (e) The location to which the resident is being relocated,
819 if known; and
820 (f) The reason that the resident is being relocated or the
821 residency is being terminated, along with a supporting
822 explanation.
823 (5) A resident may be relocated or have his or her
824 residency terminated by the facility only if:
825 (a) The resident’s needs cannot be met in the facility;
826 (b) The resident no longer needs the services provided by
827 the facility;
828 (c) The health or safety of individuals in the facility is
829 endangered by the resident;
830 (d) The resident, resident’s family, or resident’s visitors
831 cause disruption in the facility’s normal environment; or
832 (e) The resident has failed, after reasonable and
833 appropriate notice, to pay.
834 (6) A resident is entitled to challenge a facility’s
835 proposed relocation or termination of residency through the
836 facility’s grievance procedure. The grievance must be filed
837 within 15 days after receipt of the notice of relocation or
838 termination of residency. If the resident files a grievance, the
839 resident may not be required to leave the facility until at
840 least 45 days after the notice of proposed relocation or
841 termination of residency is received by the resident or the
842 resident’s legal guardian or representative.
843 (7) A resident may request that the local long-term care
844 ombudsman council review any notice of relocation or termination
845 of residency given to the resident. If requested, the local
846 long-term care ombudsman council shall assist the resident, or
847 the resident’s legal guardian or representative, with filing a
848 grievance and completing the grievance process.
849 (8) Unless an emergency relocation is necessary as provided
850 in this section, the facility may not impede the resident’s
851 right to remain in the facility, and the resident may remain in
852 the facility until the outcome of the grievance, which must be
853 completed within 45 days after receipt of the notice of
854 relocation or termination of residency, unless both the facility
855 and the resident, or the resident’s legal guardian or
856 representative, agree to extend the deadline for the conclusion
857 of the grievance process. The facility must ensure that
858 responsible representatives of the facility are reasonably
859 available to participate in the grievance process.
860 (9) This section applies to relocations or terminations of
861 residency which are initiated by the assisted living facility,
862 and does not apply to those initiated by the resident or by the
863 resident’s physician, legal guardian, or representative.
864 (10) This section does not affect the rights the resident
865 has to seek civil remedies.
866 Section 14. Section 429.34, Florida Statutes, is amended to
867 read:
868 429.34 Right of entry and inspection.—
869 (1) In addition to the requirements of s. 408.811, a any
870 duly designated officer or employee of the department, the
871 Department of Children and Family Services, the Medicaid Fraud
872 Control Unit of the Office of the Attorney General, the state or
873 local fire marshal, or a member of the state or local long-term
874 care ombudsman council shall have the right to enter unannounced
875 upon and into the premises of any facility licensed pursuant to
876 this part in order to determine the state of compliance with the
877 provisions of this part, part II of chapter 408, and applicable
878 rules. Data collected by the state or local long-term care
879 ombudsman councils or the state or local advocacy councils may
880 be used by the agency in investigations involving violations of
881 regulatory standards.
882 (2) The agency is designated the central agency for
883 tracking complaints that involve potential licensure violations
884 to ensure a timely response to allegations regarding facilities
885 and the initiation of licensure enforcement action, if
886 warranted. Any other state agency regulating, or providing
887 services to residents of, assisted living facilities, including
888 the department, the Long-Term Care Ombudsman Council, and the
889 Department of Children and Family Services, must report any
890 allegations or complaints that have been substantiated or are
891 likely to have occurred to the agency within 2 business days if
892 the report reflects serious and immediate risk to residents. All
893 other referrals must be made within 10 business days.
894 (3) The agency shall have lead surveyors in each field
895 office who specialize in assessing assisted living facilities.
896 The lead surveyors shall provide initial and ongoing training to
897 surveyors who will be inspecting and monitoring facilities. The
898 lead surveyors shall ensure that consistent inspection and
899 monitoring assessments are conducted.
900 (4) The agency shall have one statewide lead surveyor who
901 specializes in assisted living facility inspections. The lead
902 surveyor shall coordinate communication between lead surveyors
903 of assisted living facilities throughout the state and ensure
904 statewide consistency in applying facility inspection laws and
905 rules.
906 Section 15. Paragraph (l) of subsection (1) and subsections
907 (2) and (5) of section 429.41, Florida Statutes, are amended to
908 read:
909 429.41 Rules establishing standards.—
910 (1) It is the intent of the Legislature that rules
911 published and enforced pursuant to this section shall include
912 criteria by which a reasonable and consistent quality of
913 resident care and quality of life may be ensured and the results
914 of such resident care may be demonstrated. Such rules shall also
915 ensure a safe and sanitary environment that is residential and
916 noninstitutional in design or nature. It is further intended
917 that reasonable efforts be made to accommodate the needs and
918 preferences of residents to enhance the quality of life in a
919 facility. The agency, in consultation with the department, may
920 adopt rules to administer the requirements of part II of chapter
921 408. In order to provide safe and sanitary facilities and the
922 highest quality of resident care accommodating the needs and
923 preferences of residents, the department, in consultation with
924 the agency, the Department of Children and Family Services, and
925 the Department of Health, shall adopt rules, policies, and
926 procedures to administer this part, which must include
927 reasonable and fair minimum standards in relation to:
928 (l) The establishment of specific policies and procedures
929 on resident elopement. Facilities shall conduct a minimum of two
930 resident elopement drills each year. All administrators and
931 direct care staff shall participate in the drills. Facilities
932 shall document the drills. Each calendar year, the agency shall
933 observe the elopement drills of 10 percent of the licensed
934 facilities in the state. The facilities must be randomly
935 selected by the agency and the elopement drills must coincide
936 with an inspection or survey conducted by the agency. If an
937 agency employee observes an elopement drill that does not meet
938 licensure standards, the agency shall cite violations in
939 accordance with s. 429.19(2).
940 (2) In adopting any rules pursuant to this part, the
941 department, in conjunction with the agency, shall make distinct
942 standards for facilities based upon facility size; the types of
943 care provided; the physical and mental capabilities and needs of
944 residents; the type, frequency, and amount of services and care
945 offered; and the staffing characteristics of the facility. Rules
946 developed pursuant to this section may shall not restrict the
947 use of shared staffing and shared programming in facilities that
948 are part of retirement communities that provide multiple levels
949 of care and otherwise meet the requirements of law and rule.
950 Except for uniform firesafety standards, the department shall
951 adopt by rule separate and distinct standards for facilities
952 with 16 or fewer beds and for facilities with 17 or more beds.
953 The standards for facilities with 16 or fewer beds must shall be
954 appropriate for a noninstitutional residential environment if,
955 provided that the structure is no more than two stories in
956 height and all persons who cannot exit the facility unassisted
957 in an emergency reside on the first floor. The department, in
958 conjunction with the agency, may make other distinctions among
959 types of facilities as necessary to enforce the provisions of
960 this part. If Where appropriate, the agency shall offer
961 alternate solutions for complying with established standards,
962 based on distinctions made by the department and the agency
963 relative to the physical characteristics of facilities and the
964 types of care offered therein.
965 (5) In order to allocate resources efficiently, the agency
966 shall conduct may use an abbreviated biennial standard licensure
967 inspection that consists of a review of key quality-of-care
968 standards in lieu of a full inspection in a facility that has a
969 good record of past performance. However, a full inspection must
970 be conducted in a facility that has a history of class I or
971 class II violations, uncorrected class III violations, confirmed
972 ombudsman council complaints that resulted in a citation for
973 licensure, or confirmed licensure complaints which resulted in a
974 citation for a licensure violation, within the previous
975 licensure period immediately preceding the inspection or if a
976 potentially serious problem is identified during the abbreviated
977 inspection. The agency, in consultation with the department,
978 shall develop the key quality-of-care standards with input from
979 the State Long-Term Care Ombudsman Council and representatives
980 of provider groups for incorporation into its rules.
981 Section 16. Subsection (1) of section 429.49, Florida
982 Statutes, is amended to read:
983 429.49 Resident records; penalties for alteration.—
984 (1) Any person who fraudulently alters, defaces, or
985 falsifies any medical or other record of an assisted living
986 facility, or causes or procures any such offense to be
987 committed, commits a misdemeanor of the first second degree,
988 punishable as provided in s. 775.082 or s. 775.083.
989 Section 17. Section 429.515, Florida Statutes, is created
990 to read:
991 429.515 Preservice orientation.—
992 (1) Each employee, including an administrator, of an
993 assisted living facility who is newly hired on or after July 1,
994 2012, must attend a preservice orientation provided by the
995 facility which covers topics that will enable the employee to
996 relate and respond to the residents of the facility. The
997 orientation must be at least 2 hours in duration, be available
998 in English and, if the employee is not fluent in English but is
999 fluent in Spanish, Spanish, and, at a minimum, cover the
1000 following topics:
1001 (a) Care of persons who have Alzheimer’s disease or other
1002 related disorders.
1003 (b) Deescalation techniques.
1004 (c) Aggression control.
1005 (d) Elopement prevention.
1006 (e) Behavior management.
1007 (2) Upon completion of the preservice orientation, the
1008 administrator or owner of the facility must sign an affidavit,
1009 under penalty of perjury, stating that the employee completed
1010 the preservice orientation. The administrator of the facility
1011 must maintain the signed affidavit in the employee’s work file.
1012 Section 18. Section 429.52, Florida Statutes, is amended to
1013 read:
1014 (Substantial rewording of section. See
1015 s. 429.52, F.S., for present text.)
1016 429.52 Training; examination; tutorial; continuing
1017 education.—
1018 (1) Staff, other than administrators, hired on or after
1019 January 1, 2013, who provide regular or direct care to residents
1020 must complete a 20-hour staff training curriculum, and
1021 interactive online tutorial that demonstrates an understanding
1022 of the training. The training and tutorial must be completed
1023 within 90 days after employment and is in addition to the
1024 preservice orientation required under s. 429.515. Any cost or
1025 fee associated with the training and tutorial shall be borne by
1026 the participant or the participant’s employer. The department
1027 may grant an exemption from the applicable hours to nurses,
1028 certified nursing assistants, or home health aides who can
1029 demonstrate completion of training that is substantially similar
1030 to all or portions of the staff training curriculum.
1031 (2) Staff, other than administrators, providing regular or
1032 direct care to residents must participate in a minimum of 4
1033 hours of continuing education every 2 years. The continuing
1034 education may be offered through online courses and any fee
1035 associated with the online service shall be borne by the
1036 participant or the participant’s employer.
1037 (3) A certificate must be provided to each person upon
1038 completion of the training required in this section. A copy of
1039 the certificate must be maintained in the employee’s work file.
1040 (4) A person who can document that he or she has completed
1041 the training and continuing education required by this section
1042 is not required to retake the training or continuing education
1043 for the applicable 2-year cycle upon employment with a different
1044 facility if the break in employment does not exceed 6 months.
1045 (5) The department, in consultation with the agency, the
1046 Department of Children and Family Services, and their agents,
1047 shall develop the following:
1048 (a) Assisted living facility administrator core training
1049 that includes at least 40 hours of training. The curriculum, at
1050 a minimum, must cover the following topics:
1051 1. State law and rules relating to assisted living
1052 facilities.
1053 2. Resident rights and the identification and reporting of
1054 abuse, neglect, and exploitation.
1055 3. The special needs of elderly persons, persons who have
1056 mental illness, and persons who have developmental disabilities
1057 and how to meet those needs.
1058 4. Nutrition and food service, including acceptable
1059 sanitation practices for preparing, storing, and serving food.
1060 5. Medication management, recordkeeping, and proper
1061 techniques for assisting residents who self-administer
1062 medication.
1063 6. Firesafety requirements, including procedures for fire
1064 evacuation drills and other emergency procedures.
1065 7. The care of persons who have Alzheimer’s disease and
1066 related disorders.
1067 8. Elopement prevention.
1068 9. Aggression and behavior management, deescalation
1069 techniques, and proper protocols and procedures relating to the
1070 Baker Act as provided in part I of chapter 394.
1071 10. Do-not-resuscitate orders.
1072 11. Infection control.
1073 12. Admission and continued residency.
1074 13. Phases of care and interacting with residents.
1075 14. Best practices in the industry.
1076 15. Business operations, including, but not limited to,
1077 human resources, financial management, and supervision of staff.
1078 (b) An assisted living facility administrator examination
1079 that tests the applicant’s knowledge and training of the core
1080 training topics listed in paragraph (a).
1081 (c) A continuing education curriculum of 16 hours for
1082 licensed assisted living facility administrators. The department
1083 or its agent shall also develop an examination that corresponds
1084 with each continuing education course. Continuing education must
1085 include topics similar to those of the core training in
1086 paragraph (a), and may include additional subject matter that
1087 enhances the knowledge, skills, and abilities of assisted living
1088 facility administrators, as adopted by rule.
1089 (d) Specialty training, continuing education, examinations,
1090 and tutorials for the requirements in paragraph (7).
1091 (6) The department, in consultation with stakeholders, the
1092 agency, and the Department of Children and Family Services shall
1093 develop the standardized staff training curriculum and
1094 continuing education required under subsections (1) and (2). The
1095 curriculum must include at least 20 hours of inservice training,
1096 with at least 1 hour of training per topic, covering at least
1097 the following topics:
1098 (a) Reporting major incidents.
1099 (b) Reporting adverse incidents.
1100 (c) Facility emergency procedures, including chain-of
1101 command and staff member roles relating to emergency evacuation.
1102 (d) Resident rights in an assisted living facility.
1103 (e) Recognizing and reporting resident abuse, neglect, and
1104 exploitation.
1105 (f) Resident behavior and needs.
1106 (g) Providing assistance with the activities of daily
1107 living.
1108 (h) Infection control.
1109 (i) Aggression and behavior management and deescalation
1110 techniques.
1111 (7) Additional specialty training and continuing education
1112 for assisted living facility staff and administrators is
1113 required as follows:
1114 (a) Administrators and staff who provide regular or direct
1115 care to residents of a facility that holds an extended
1116 congregate care license must complete a minimum of 4 hours of
1117 extended congregate care training within 90 days after beginning
1118 employment or after the facility receives an extended congregate
1119 care license and 2 hours of continuing education every 2 years.
1120 (b) If a facility holds a limited nursing services license:
1121 1. The administrator must complete a minimum of 4 hours of
1122 courses that train and educate administrators on the special
1123 needs and care of those residents requiring limited nursing
1124 services within 90 days after employment or after the facility
1125 receives a limited nursing services license.
1126 2. Staff providing regular and direct care to residents
1127 receiving limited nursing services must complete a minimum of 2
1128 hours of courses that train and educate staff on the special
1129 needs and care of those requiring limited nursing services. The
1130 training must be completed within 90 days after employment or
1131 after the facility receives a limited nursing services license.
1132 (c) Staff who provide regular or direct care to mental
1133 health residents and administrators who are employed by a
1134 facility that holds a limited mental health license must
1135 complete a minimum of 8 hours of department-approved mental
1136 health training within 90 days after beginning employment or
1137 after the facility receives a limited mental health license.
1138 Staff and administrators must also complete 2 hours of
1139 continuing education that enhances the ability to care for
1140 mental health residents. A staff member must complete an online
1141 interactive tutorial related to the training and continuing
1142 education in order to demonstrate an understanding of the
1143 material and receive a certificate of completion. An
1144 administrator must pass an examination related to the
1145 administrator’s training with a minimum score of 80 percent. An
1146 administrator must complete an online interactive tutorial
1147 related to the continuing education in order to demonstrate an
1148 understanding of the material and receive a certificate of
1149 completion. The participant or the participant’s employer shall
1150 pay any fee associated with the training, tutorial, or
1151 examination.
1152 1. A staff member who does not complete the initial
1153 training tutorial within the 90 days may not provide regular or
1154 direct care to mental health residents until he or she
1155 successfully completes the tutorial.
1156 2. An administrator who does not pass the examination
1157 within 6 months after completing the mental health training may
1158 not be an administrator of a facility that holds a limited
1159 mental health license until the administrator achieves a passing
1160 score.
1161 (d) Staff, including administrators, who prepare or serve
1162 food must receive a minimum of 1 hour of inservice training in
1163 safe food handling practices within 30 days after beginning
1164 employment.
1165 (e) Staff, including administrators, must receive at least
1166 1 hour of inservice training on the facility’s resident
1167 elopement response policies and procedures within 30 days after
1168 beginning employment.
1169 1. A copy of the facility’s resident elopement response
1170 policies and procedures must be provided to staff and the
1171 administrator.
1172 2. Staff members and the administrator must demonstrate
1173 understanding and competency in the implementation of the
1174 elopement response policies and procedures.
1175 (f) Staff, including the administrator, involved with the
1176 management of medications and the assistance with self
1177 administration of medications under s. 429.256 must complete a
1178 minimum of 4 additional hours of training provided by a
1179 registered nurse, licensed pharmacist, or department staff
1180 member. The department shall establish by rule the minimum
1181 requirements of this training, including continuing education
1182 requirements.
1183 (8) Other facility staff members shall participate in
1184 training relevant to their job duties and as specified by rule.
1185 (9) The department, in consultation with a panel of at
1186 least three mental health professionals, the agency, and the
1187 Department of Children and Family Services, and their agents
1188 shall develop a limited mental health curriculum, examination,
1189 and on-line interactive tutorial.
1190 (10) The agency or department may require or cause to be
1191 provided the training or education of staff of an assisted
1192 living facility beyond that which is required under this part if
1193 the agency or department determines that there are problems in a
1194 facility which could be reduced through specific staff training
1195 or education.
1196 (11) Existing curricula, examinations, and tutorials may be
1197 used, modified, or enhanced as appropriate. To the extent
1198 funding is available, the department may contract for assistance
1199 with the development, review, updating of the training,
1200 examinations, and on-line tutorials required under this section.
1201
1202 All training, examinations, and tutorials must be developed and
1203 offered in English and Spanish, and must be reviewed at least
1204 annually and updated as needed to reflect changes in the law,
1205 rules, and best practices.
1206 Section 19. Section 429.522, Florida Statutes, is created
1207 to read:
1208 429.522 Assisted living training providers; certification.—
1209 (1) Effective January 1, 2013, an individual seeking to
1210 provide assisted living training in this state must be certified
1211 by the department. The applicant must provide the department
1212 with proof of completion of the minimum core training
1213 requirements, successful passage of the assisted living facility
1214 administrator licensure examination, and proof of compliance
1215 with continuing education requirements for assisted living
1216 facility administrators since completion of training.
1217 (2) A person seeking to be certified as a trainer must
1218 also:
1219 (a) Provide proof of completion of a 4-year baccalaureate
1220 degree from an accredited college or university and must have
1221 worked in a management position in an assisted living facility
1222 for 3 years after obtaining certification in core training
1223 courses;
1224 (b) Have worked in a management position in an assisted
1225 living facility for 5 years;
1226 (c) Have been previously employed as a trainer of core
1227 training courses for the department;
1228 (d) Have at least 5 years of employment with the agency as
1229 a surveyor of assisted living facilities;
1230 (e) Have at least 5 years of employment as an educator or
1231 staff trainer for persons working in an assisted living facility
1232 or another long-term care setting;
1233 (f) Have a 4-year baccalaureate degree from an accredited
1234 college or university in the areas of health care, gerontology,
1235 social work, education, or human services and at least 4 years
1236 of experience as an educator or staff trainer for persons
1237 working in an assisted living facility or another long-term care
1238 setting after receiving certification in core courses; or
1239 (g) Meet other qualification criteria as defined by rule of
1240 the department.
1241 (3) Training may also be provided by faculty in a Florida
1242 College System institution.
1243 (4) The department shall provide oversight of the assisted
1244 living training providers. The department shall adopt rules to
1245 establish requirements for trainer certification and
1246 recertification requirements, including continuing education
1247 requirments, disciplinary action that may be taken against a
1248 trainer, a trainer decertification process, and required
1249 electronic reporting of persons who have successfully completing
1250 training courses.
1251 (5) If funding is available, by January 1, 2013, the
1252 department shall develop and maintain an electronic database,
1253 accessible to the public, which lists all persons holding
1254 certification as an assisted living trainer, including any
1255 history of violations. Assisted living trainers shall keep a
1256 record of individuals who complete training and shall submit the
1257 record to the department electronically within 24 hours after
1258 the completion of a course in order for the department to
1259 include the information in the database.
1260 Section 20. Section 429.54, Florida Statutes, is amended to
1261 read:
1262 429.54 Collection of information; local subsidy;
1263 interagency communication; facility reporting.—
1264 (1) To enable the department to collect the information
1265 requested by the Legislature regarding the actual cost of
1266 providing room, board, and personal care in assisted living
1267 facilities, the department may is authorized to conduct field
1268 visits and audits of facilities as may be necessary. The owners
1269 of randomly sampled facilities shall submit such reports,
1270 audits, and accountings of cost as the department may require by
1271 rule; however, provided that such reports, audits, and
1272 accountings may not be more than shall be the minimum necessary
1273 to implement the provisions of this subsection section. Any
1274 facility selected to participate in the study shall cooperate
1275 with the department by providing cost of operation information
1276 to interviewers.
1277 (2) Local governments or organizations may contribute to
1278 the cost of care of local facility residents by further
1279 subsidizing the rate of state-authorized payment to such
1280 facilities. Implementation of local subsidy shall require
1281 departmental approval and may shall not result in reductions in
1282 the state supplement.
1283 (3) Subject to the availability of funds, the agency, the
1284 department, the Department of Children and Family Services, and
1285 the Agency for Persons with Disabilities shall develop or modify
1286 electronic systems of communication among state-supported
1287 automated systems to ensure that relevant information pertaining
1288 to the regulation of assisted living facilities and facility
1289 staff is timely and effectively communicated among agencies in
1290 order to facilitate the protection of residents.
1291 (4) All assisted living facilities shall submit electronic
1292 reports to the agency twice a year.
1293 (a) The reports must represent facility data on March 30
1294 and September 30 of each year and be submitted within 15
1295 calendar days. The following information and must be submitted:
1296 1. The number of beds in the facility;
1297 2. The number of occupied beds;
1298 3. The number of residents, by age group, younger than 65
1299 years of age, from 65 to 74 years of age, from 75 to 84 years of
1300 age, and 85 years of age or older;
1301 4. The number of residents who are mental health residents,
1302 who are receiving extended congregate care, who are receiving
1303 limited nursing services, and who are receiving hospice care;
1304 5. If there is a facility waiting list, the number of
1305 individuals on the waiting list and the type of services or care
1306 they require, if known;
1307 6. The number of residents receiving optional state
1308 supplementation; and
1309 7. The number of residents who are Medicaid recipients and
1310 the type of waiver used to fund their assisted living facility
1311 certification care.
1312 (b) The agency must maintain electronically the electronic
1313 information submitted and, at a minimum, use the information to
1314 track trends in resident populations and needs.
1315 (c) Reporting under this subsection begins March 1, 2013,
1316 and expires July 1, 2017.
1317 Section 21. Section 429.55, Florida Statutes, is created to
1318 read:
1319 429.55 Assisted living facility rating system.—
1320 (1) The agency, in consultation with the department, the
1321 Department of Children and Family Services, and the Office of
1322 State Long-Term Care Ombudsman, shall develop and adopt by rule
1323 a user-friendly assisted living facility rating system.
1324 (2) The rating system must be publicly available on the
1325 Internet in order to assist consumers in evaluating assisted
1326 living facilities and the services provided by such facilities.
1327 (3) The rating system must be based on resident
1328 satisfaction, the number and class of deficiencies for which the
1329 facility has been cited, agency inspection reports, the
1330 inspection reports of any other regulatory agency, assessments
1331 conducted by the ombudsman program pursuant to part I of chapter
1332 400, and other criteria as determined by the agency.
1333 (4) The Internet home page for the rating system must
1334 include a link that allows consumers to complete a voluntary
1335 survey that provides feedback on whether the rating system is
1336 helpful and suggestions for improvement.
1337 (5) The agency may adopt rules as necessary to administer
1338 this section.
1339 Section 22. The Division of Statutory Revision is requested
1340 to rename part II of chapter 468, Florida Statutes, consisting
1341 of ss. 468.1635-468.1756, Florida Statutes, as “Nursing Home and
1342 Assisted Living Facility Administration.”
1343 Section 23. Section 468.1635, Florida Statutes, is amended
1344 to read:
1345 468.1635 Purpose.—The sole legislative purpose for enacting
1346 this part chapter is to ensure that every nursing home
1347 administrator and assisted living facility administrator
1348 practicing in this state meets minimum requirements for safe
1349 practice. It is the legislative intent that nursing home
1350 administrators and assisted living facility administrators who
1351 fall below minimum competency or who otherwise present a danger
1352 to the public shall be prohibited from practicing in this state.
1353 Section 24. Section 468.1645, Florida Statutes, is amended
1354 to read:
1355 468.1645 Administrator license required.—
1356 (1) A No nursing home in the state may not operate in this
1357 state unless it is under the management of a nursing home
1358 administrator, and effective July 1, 2013, an assisted living
1359 facility may not operate in this state unless it is under the
1360 management of an assisted living facility administrator who
1361 holds a currently valid license, provisional license, or
1362 temporary license.
1363 (2) Nothing in This part, and or in the rules adopted
1364 pursuant to this part, do not hereunder shall require an
1365 administrator of a any facility or institution operated by and
1366 for persons who rely exclusively upon treatment by spiritual
1367 means through prayer, in accordance with the creed or tenets of
1368 any organized church or religious denomination, to be licensed
1369 as a nursing home administrator or assisted living facility
1370 administrator if the administrator is employed only to
1371 administer in such facilities or institutions for the care and
1372 treatment of the sick.
1373 Section 25. Section 468.1655, Florida Statutes, is amended
1374 to read:
1375 468.1655 Definitions.—As used in this part:
1376 (1) “Assisted living facility” means a facility licensed
1377 under part I of chapter 429.
1378 (2) “Assisted living facility administrator” means a person
1379 who is licensed to engage in the practice of assisted living
1380 facility administration in this state under the authority of
1381 this part.
1382 (3) “Assisted living facility administrator certification”
1383 means a professional credential awarded by a board-approved
1384 third-party credentialing entity to individuals who demonstrate
1385 core competency in the practice of assisted living facility
1386 administration and who meet the education, background screening,
1387 and other criteria specified by the board for licensure as an
1388 assisted living facility administrator.
1389 (4)(1) “Board” means the Board of Long-Term Care Nursing
1390 Home Administrators.
1391 (5)(2) “Department” means the Department of Health.
1392 (6) “Long-term care” means any service provided in
1393 facilities licensed under part II of chapter 400 or part I of
1394 chapter 429.
1395 (7)(3) “Nursing home administrator” means a person who is
1396 licensed to engage in the practice of nursing home
1397 administration in this state under the authority of this part.
1398 (8) “Practice of assisted living facility administration”
1399 means any service requiring education, training, or experience
1400 in assisted living facility administration and its application
1401 to the planning, organizing, staffing, directing, and
1402 controlling of the total management of an assisted living
1403 facility. A person is practicing or offering to practice
1404 assisted living facility administration if such person:
1405 (a) Practices any of the above services.
1406 (b) Holds himself or herself out as able to perform, or
1407 does perform, any form of assisted living facility
1408 administration by written or verbal claim, sign, advertisement,
1409 letterhead, or card; or in any other way represents himself or
1410 herself to be, or implies that he or she is, an assisted living
1411 facility administrator.
1412 (9)(4) “Practice of nursing home administration” means any
1413 service requiring education, training, or experience in nursing
1414 home administration education, training, or experience and the
1415 application of such to the planning, organizing, staffing,
1416 directing, and controlling of the total management of a nursing
1417 home. A person is practicing or offering shall be construed to
1418 practice or to offer to practice nursing home administration if
1419 the person who:
1420 (a) Practices any of the above services.
1421 (b) Holds himself or herself out as able to perform, or
1422 does perform, any form of nursing home administration by written
1423 or verbal claim, sign, advertisement, letterhead, or card; or in
1424 any other way represents himself or herself to be, or implies
1425 that he or she is, a nursing home administrator.
1426 (10)(5) “Nursing home” means an institution or facility
1427 licensed as such under part II of chapter 400.
1428 Section 26. Section 468.1665, Florida Statutes, is amended
1429 to read:
1430 468.1665 Board of Long-Term Care Nursing Home
1431 Administrators; membership; appointment; terms.—
1432 (1) The Board of Long-Term Care Nursing Home Administrators
1433 is created within the department and shall consist of eleven
1434 seven members, to be appointed by the Governor and confirmed by
1435 the Senate to a term of 4 years or for a term to complete an
1436 unexpired vacancy.
1437 (2) Three members of the board must be licensed nursing
1438 home administrators. Three members of the board must be licensed
1439 assisted living facility administrators. Two members of the
1440 board must be health care practitioners. Three The remaining two
1441 members of the board must be laypersons who are not, and have
1442 never been, nursing home or assisted living facility
1443 administrators or members of any health care profession or
1444 occupation, and at least one of these laypersons must be a
1445 resident of an assisted living facility. At least one member of
1446 the board must be 60 years of age or older.
1447 (3) Only board members who are nursing home administrators
1448 may have a direct financial interest in any nursing home. Only
1449 board members who are assisted living facility administrators
1450 may have a direct financial interest in any assisted living
1451 facility.
1452 (4) All provisions of chapter 456 relating to activities of
1453 regulatory boards shall apply.
1454 Section 27. Section 468.1685, Florida Statutes, is amended
1455 to read:
1456 468.1685 Powers and duties of board and department.—It is
1457 the function and duty of the board, together with the
1458 department, to:
1459 (1) Adopt rules pursuant to ss. 120.536(1) and 120.54 to
1460 implement the provisions of this part conferring duties upon the
1461 board.
1462 (2) Develop, impose, and enforce specific standards within
1463 the scope of the general qualifications established by this part
1464 which must be met by individuals in order to receive licenses as
1465 nursing home or assisted living facility administrators. These
1466 standards shall be designed to ensure that nursing home and
1467 assisted living facility administrators are individuals of good
1468 character and otherwise suitable and, by training or experience
1469 in the field of health care facility institutional
1470 administration, qualified to serve as nursing home or assisted
1471 living facility administrators.
1472 (3) Develop by appropriate techniques, including
1473 examinations and investigations, a method for determining
1474 whether an individual meets such standards.
1475 (a) The board shall approve one or more third-party
1476 credentialing entities for the purpose of developing and
1477 administering certification programs for assisted living
1478 facility administrators. A third-party credentialing entity must
1479 be a nonprofit organization that has met nationally recognized
1480 standards for developing and administering professional
1481 certification programs.
1482 (b) In order to obtain approval, a third-party
1483 credentialing entity must also:
1484 1. Establish professional requirements and standards that
1485 applicants must achieve in order to obtain an assisted living
1486 facility administrator certification and to maintain such
1487 certification. At a minimum, these requirements and standards
1488 must include completion of the requirements for assisted living
1489 facility administrators required in this part and in rules
1490 adopted by the board, including all education, experience, and
1491 continuing education requirements;
1492 2. Agree to assist the Department of Elderly Affairs with
1493 developing the training and testing materials under section
1494 429.52 using nationally recognized certification and
1495 psychometric standards;
1496 3. Maintain an Internet-based database, accessible to the
1497 public, of all persons holding an assisted living facility
1498 administrator certification; and
1499 4. Require continuing education and, at least, biennial
1500 certification renewal for persons holding an assisted living
1501 facility administrator certification.
1502 (4) Issue licenses to qualified individuals meeting the
1503 standards of the board and revoke or suspend licenses previously
1504 issued by the board if when the individual holding such license
1505 is determined to have failed to conform substantially conform to
1506 the requirements of such standards.
1507 (5) Establish by rule and carry out procedures, by rule,
1508 designed to ensure that licensed nursing home or assisted living
1509 facility administrators will comply with the standards adopted
1510 by the board.
1511 (6) Receive, investigate, and take appropriate action with
1512 respect to any charge or complaint filed with the department to
1513 the effect that a licensed nursing home or assisted living
1514 facility administrator has failed to comply with the
1515 requirements or standards adopted by the board.
1516 (7) Conduct a continuing study and investigation of nursing
1517 homes and assisted living facilities and the administrators of
1518 nursing homes and assisted living facilities in order to improve
1519 the standards imposed for the licensing of such administrators
1520 and the procedures and methods for enforcing such standards with
1521 respect to licensed administrators of nursing homes who have
1522 been licensed as such.
1523 (8) Set up procedures by rule for advising and acting
1524 together with the department of Health and other boards of other
1525 health professions in matters affecting procedures and methods
1526 for effectively enforcing the purpose of this part and the
1527 administration of chapters 400 and 429.
1528 Section 28. Section 468.1695, Florida Statutes, is amended
1529 to read:
1530 468.1695 Licensure by examination; licensure by
1531 certification.—
1532 (1) Any person desiring to be licensed as a nursing home
1533 administrator shall apply to the department to take the
1534 licensure examination. The examination shall be given at least
1535 two times a year and shall include, but not be limited to,
1536 questions on the subjects of nursing home administration such
1537 as:
1538 (a) Applicable standards of nursing home health and safety;
1539 (b) Federal, state, and local health and safety laws and
1540 rules;
1541 (c) General administration;
1542 (d) Psychology of patient care;
1543 (e) Principles of medical care;
1544 (f) Personal and social care;
1545 (g) Therapeutic and supportive care and services in long
1546 term care;
1547 (h) Departmental organization and management;
1548 (i) Community interrelationships; and
1549 (j) Terminology.
1550
1551 The board may, by rule, adopt use of a national examination in
1552 lieu of part or all of the examination required by this part.
1553 (2) The department shall examine each applicant for a
1554 nursing home administrator license who the board certifies has
1555 completed the application form and remitted an examination fee
1556 set by the board not to exceed $250 and who:
1557 (a)1. Holds a baccalaureate degree from an accredited
1558 college or university and majored in health care administration
1559 or has credit for at least 60 semester hours in subjects, as
1560 prescribed by rule of the board, which prepare the applicant for
1561 total management of a nursing home; and
1562 2. Has fulfilled the requirements of a college-affiliated
1563 or university-affiliated internship in nursing home
1564 administration or of a 1,000-hour nursing home administrator-in
1565 training program prescribed by the board; or
1566 (b)1. Holds a baccalaureate degree from an accredited
1567 college or university; and
1568 2.a. Has fulfilled the requirements of a 2,000-hour nursing
1569 home administrator-in-training program prescribed by the board;
1570 or
1571 b. Has 1 year of management experience allowing for the
1572 application of executive duties and skills, including the
1573 staffing, budgeting, and directing of resident care, dietary,
1574 and bookkeeping departments within a skilled nursing facility,
1575 hospital, hospice, assisted living facility with a minimum of 60
1576 licensed beds, or geriatric residential treatment program and,
1577 if such experience is not in a skilled nursing facility, has
1578 fulfilled the requirements of a 1,000-hour nursing home
1579 administrator-in-training program prescribed by the board.
1580 (3) The department shall issue a license to practice
1581 nursing home administration to any applicant who successfully
1582 completes the examination in accordance with this section and
1583 otherwise meets the requirements of this part. The department
1584 shall not issue a license to any applicant who is under
1585 investigation in this state or another jurisdiction for an
1586 offense which would constitute a violation of s. 468.1745 or s.
1587 468.1755. Upon completion of the investigation, the provisions
1588 of s. 468.1755 shall apply.
1589 (4) The board may by rule establish a preceptor
1590 certification and recertification fee not to exceed $100 which
1591 shall be remitted by those individuals seeking board approval to
1592 act as preceptors in administrator-in-training programs as
1593 prescribed by the board. This Said fee may be charged at the
1594 time of application for initial certification and at the time of
1595 application for recertification. The board may by rule establish
1596 a trainee application fee not to exceed $500 to defray the costs
1597 of the board’s supervision of the administrator-in-training
1598 program, to be remitted by those individuals seeking to undergo
1599 a board prescribed administrator-in-training program.
1600 (5) Any person desiring to be licensed as an assisted
1601 living facility administrator must apply to the department,
1602 remit a nonrefundable fee set by the board not to exceed $150,
1603 and provide proof of a current and valid assisted living
1604 facility administrator certification.
1605 (6) An assisted living facility administrator certification
1606 must be issued by a board-approved third-party credentialing
1607 entity that certifies that the individual:
1608 (a) Is at least 21 years old;
1609 (b) Holds a 4-year baccalaureate degree from an accredited
1610 college or university, including completion of coursework in
1611 health care, gerontology, or geriatrics; holds a 4-year
1612 baccalaureate degree from an accredited college or university
1613 and has at least 2 years of experience in direct care in or
1614 management of an assisted living facility or nursing home; or
1615 holds a 2-year associate degree and has at least 4 years of
1616 experience in direct care in an assisted living facility or
1617 nursing home;
1618 (c) Has completed a least 40 hours of core training;
1619 (d) Has passed an examination that documents core
1620 competencies in the training required for assisted living
1621 facility administrators prior to licensure with a minimum score
1622 of 80 percent;
1623 (e) Has completed background screening pursuant to ss.
1624 429.174 and 456.0365; and
1625 (f) Otherwise meets the requirements of this part and part
1626 I of chapter 429.
1627 (7) An assisted living facility administrator who is
1628 continuously employed as a facility administrator, or a nursing
1629 home administrator who is continuously employed as a nursing
1630 home administrator, for at least the 2 years before January 1,
1631 2013, is eligible for certification as an assisted living
1632 facility administrator without meeting the requirements in
1633 subsection (6) if:
1634 (a) The applicant completed the core training, examination,
1635 and continuing education requirements under chapter 429 which
1636 were in effect on June 30, 2012; and
1637 (b) The applicant was not the administrator of a facility
1638 or nursing home that was cited for a class I or class II
1639 violation within the 2 years before January 1, 2013.
1640 (8) Other licensed professionals may be exempted from some
1641 or all of the training requirements of this section for assisted
1642 living facility administrator certification, as determined by
1643 the board, in consultation with the Department of Elderly
1644 Affairs and the Agency for Health Care Administration, by rule.
1645 (9) A licensed assisted living facility administrator
1646 applying for relicensure must submit an application, remit a
1647 renewal fee of $150, and demonstrate that he or she has obtained
1648 and maintained his or her assisted living facility administrator
1649 certification that substantiates that he or she has completed at
1650 least 16 hours of general continuing education, any specialty
1651 training and continuing education required based on licensure of
1652 the facility for which the applicant is an administrator, has
1653 successfully passed all required examinations, and satisfies all
1654 other requirements for licensure renewal under this part and
1655 part I of chapter 429.
1656 (10) The board may adopt rules for licensure forms,
1657 staggered license expirations dates, prorated licensure fees,
1658 and certification to implement the licensure and relicensure of
1659 assisted living facility administrators.
1660 Section 29. Subsection (1) of section 468.1705, Florida
1661 Statutes, is amended to read:
1662 468.1705 Licensure by endorsement; temporary license.—
1663 (1) The department shall issue a nursing home administrator
1664 license by endorsement to an any applicant who, upon applying to
1665 the department and remitting a fee set by the board not to
1666 exceed $500, demonstrates to the board that he or she:
1667 (a) Meets one of the following requirements:
1668 1. Holds a valid active license to practice nursing home
1669 administration in another state of the United States if,
1670 provided that the current requirements for licensure in that
1671 state are substantially equivalent to, or more stringent than,
1672 current requirements in this state; or
1673 2. Meets the qualifications for licensure in s. 468.1695;
1674 and
1675 (b)1. Has successfully completed a national examination
1676 which is substantially equivalent to, or more stringent than,
1677 the examination given by the department;
1678 2. Has passed an examination on the laws and rules of this
1679 state governing the administration of nursing homes; and
1680 3. Has worked as a fully licensed nursing home
1681 administrator for 2 years within the 5-year period immediately
1682 preceding the application by endorsement.
1683 Section 30. Section 468.1745, Florida Statutes, is amended
1684 to read:
1685 468.1745 Prohibitions; penalties.—
1686 (1) A No person may not shall:
1687 (a) Practice nursing home administration unless the person
1688 holds an active license to practice nursing home administration.
1689 (b) Use the name or title “nursing home administrator” if
1690 when the person has not been licensed pursuant to this part act.
1691 (c) Present as his or her own the license of another.
1692 (d) Give false or forged evidence to the board or a member
1693 thereof for the purpose of obtaining a license.
1694 (e) Use or attempt to use a nursing home administrator’s
1695 license or an assisted living facility administrator’s license
1696 that which has been suspended or revoked.
1697 (f) Knowingly employ unlicensed persons in the practice of
1698 nursing home administration or assisted living facility
1699 administration.
1700 (g) Knowingly conceal information relative to violations of
1701 this part.
1702 (h) Practice assisted living facility administration unless
1703 the person holds an active license to practice assisted living
1704 facility administration.
1705 (i) Use the name or title “assisted living facility
1706 administrator” if the person has not been licensed pursuant to
1707 this part.
1708 (2) Any person who violates the provisions of this section
1709 is guilty of a misdemeanor of the second degree, punishable as
1710 provided in s. 775.082 or s. 775.083.
1711 Section 31. Section 468.1755, Florida Statutes, is amended
1712 to read:
1713 468.1755 Disciplinary proceedings.—
1714 (1) The following acts constitute grounds for denial of a
1715 nursing home administrator license, assisted living facility
1716 administrator license, or disciplinary action, as specified in
1717 s. 456.072(2):
1718 (a) Violation of any provision of s. 456.072(1) or s.
1719 468.1745(1).
1720 (b) Attempting to procure a license to practice nursing
1721 home administration or assisted living facility administration
1722 by bribery, by fraudulent misrepresentation, or through an error
1723 of the department or the board.
1724 (c) Having a license to practice nursing home
1725 administration or assisted living facility administration
1726 revoked, suspended, or otherwise acted against, including the
1727 denial of licensure, by the licensing authority of another
1728 state, territory, or country.
1729 (d) Being convicted or found guilty, regardless of
1730 adjudication, of a crime in any jurisdiction which relates to
1731 the practice of nursing home administration, assisted living
1732 facility administration, or the ability to practice nursing home
1733 administration or assisted living facility administration. Any
1734 plea of nolo contendere shall be considered a conviction for
1735 purposes of this part.
1736 (e) Making or filing a report or record which the licensee
1737 knows to be false, intentionally failing to file a report or
1738 record required by state or federal law, willfully impeding or
1739 obstructing such filing, or inducing another person to impede or
1740 obstruct such filing. Such reports or records shall include only
1741 those which are signed in the capacity of a licensed nursing
1742 home administrator or licensed assisted living facility
1743 administrator.
1744 (f) Authorizing the discharge or transfer of a resident by
1745 a nursing home administrator for a reason other than those
1746 provided in ss. 400.022 and 400.0255.
1747 (g) Advertising goods or services in a manner which is
1748 fraudulent, false, deceptive, or misleading in form or content.
1749 (h) Fraud or deceit, negligence, incompetence, or
1750 misconduct in the practice of nursing home administration or
1751 assisted living facility administration.
1752 (i) Violation of a lawful order of the board or department
1753 previously entered in a disciplinary hearing or failing to
1754 comply with a lawfully issued subpoena of the board or
1755 department.
1756 (j) Practicing with a revoked, suspended, inactive, or
1757 delinquent license.
1758 (k) Repeatedly acting in a manner inconsistent with the
1759 health, safety, or welfare of the patients of the facility in
1760 which he or she is the administrator.
1761 (l) Being unable to practice nursing home administration or
1762 assisted living facility administration with reasonable skill
1763 and safety to patients by reason of illness, drunkenness, use of
1764 drugs, narcotics, chemicals, or any other material or substance
1765 or as a result of any mental or physical condition. In enforcing
1766 this paragraph, upon a finding of the State Surgeon General or
1767 his or her designee that probable cause exists to believe that
1768 the licensee is unable to serve as a nursing home administrator
1769 or assisted living facility administrator due to the reasons
1770 stated in this paragraph, the department shall have the
1771 authority to issue an order to compel the licensee to submit to
1772 a mental or physical examination by a physician designated by
1773 the department. If the licensee refuses to comply with such
1774 order, the department’s order directing such examination may be
1775 enforced by filing a petition for enforcement in the circuit
1776 court where the licensee resides or serves as a nursing home
1777 administrator or assisted living facility administrator. The
1778 licensee against whom the petition is filed shall not be named
1779 or identified by initials in any public court records or
1780 documents, and the proceedings shall be closed to the public.
1781 The department shall be entitled to the summary procedure
1782 provided in s. 51.011. A licensee affected under this paragraph
1783 shall have the opportunity, at reasonable intervals, to
1784 demonstrate that he or she can resume the competent practice of
1785 nursing home administration or assisted living facility
1786 administration with reasonable skill and safety to patients.
1787 (m) Willfully or repeatedly violating any of the provisions
1788 of the law, code, or rules of the licensing or supervising
1789 authority or agency of the state or political subdivision
1790 thereof having jurisdiction of the operation and licensing of
1791 nursing homes or assisted living facilities.
1792 (n) Paying, giving, causing to be paid or given, or
1793 offering to pay or to give to any person a commission or other
1794 valuable consideration for the solicitation or procurement,
1795 either directly or indirectly, of nursing home usage or assisted
1796 living facility usage, except as specifically authorized by law.
1797 (o) Willfully permitting unauthorized disclosure of
1798 information relating to a patient or his or her records.
1799 (p) Discriminating with respect to patients, residents,
1800 employees, or staff on account of race, religion, color, sex, or
1801 national origin.
1802 (q) Failing to implement an ongoing quality assurance
1803 program by a nursing home administrator which is directed by an
1804 interdisciplinary team that meets at least every other month.
1805 (r) Violating any provision of this chapter or chapter 456,
1806 or any rules adopted pursuant thereto.
1807 (2) The board may enter an order denying nursing home
1808 administrator licensure, assisted living facility administrator
1809 licensure, or imposing any of the penalties in s. 456.072(2)
1810 against any applicant for licensure or licensee who:
1811 (a) Is found guilty of violating any provision of
1812 subsection (1) of this section or who is found guilty of
1813 violating any provision of s. 456.072(1).
1814 (b) Has a controlling interest in or knowingly participates
1815 in one or more violations at an assisted living facility or
1816 nursing home which results in denial or revocation of an
1817 assisted living facility license or nursing home license.
1818 (c) Has a controlling interest in or knowingly operates an
1819 unlicensed assisted living facility.
1820 (3) The board shall revoke the license of an assisted
1821 living facility administrator who knowingly participates in
1822 intentional misconduct or engages in conduct that constitutes
1823 gross negligence which contributes to the death of a resident.
1824 (4)(3) The department shall reissue the license of a
1825 disciplined licensee upon certification by the board that the
1826 disciplined licensee has complied with all of the terms and
1827 conditions set forth in the final order.
1828 Section 32. Section 468.1756, Florida Statutes, is amended
1829 to read:
1830 468.1756 Statute of limitations.—An administrative
1831 complaint may only be filed pursuant to s. 456.073 for an act
1832 listed in s. 468.1755 s. 468.1755(1)(c)-(q) within 4 years after
1833 from the time of the incident giving rise to the complaint, or
1834 within 4 years after from the time the incident is discovered or
1835 should have been discovered.
1836 Section 33. Assisted living facility streamlining task
1837 force.—
1838 (1) The Agency for Health Care Administration shall create
1839 a task force consisting of at least one representative of the
1840 agency, the Department of Elderly Affairs, the Department of
1841 Children and Family Services, the Department of Health, and the
1842 Office of State Long-Term Care Ombudsman.
1843 (2) The purpose of the task force is to determine whether
1844 agencies currently have overlapping regulatory responsibilities
1845 over assisted living facilities and whether increased efficiency
1846 and effectiveness may be realized by transferring,
1847 consolidating, eliminating, or modifying such oversight between
1848 agencies.
1849 (3) The task force shall meet at least three times and
1850 submit a report to the Governor, the President of the Senate,
1851 and the Speaker of the House of Representatives by January 1,
1852 2013, which includes the task force’s findings and
1853 recommendations pertaining to streamlining agency oversight and
1854 improving the effectiveness of regulatory functions.
1855 (4) The task force is terminated effective March 1, 2013.
1856 Section 34. By January 1, 2013, the Agency for Health Care
1857 Administration shall submit copies of all of its inspection
1858 forms used to inspect assisted living facilities to the Office
1859 of State Long-Term Care Ombudsman. The office shall create and
1860 act as the chair of a task force of up to 11 members, consisting
1861 of an ombudsman, one representative of a nonprofit assisted
1862 living facility, one representative of a for-profit assisted
1863 living facility, at least one resident or family member of a
1864 resident, other stakeholders, and one representative of the
1865 agency, the Department of Elderly Affairs, the Department of
1866 Children and Family Services, and the Department of Health, to
1867 review the inspection forms. The task force shall provide
1868 recommendations, if any, to modify the forms in order to ensure
1869 that inspections adequately assess whether the assisted living
1870 facilities are in compliance with the law, meet the needs of
1871 residents, and ensure resident safety. The task force must
1872 provide its recommendations, including explanations of its
1873 recommendations, to the agency within 90 days after receiving
1874 the inspection forms. The task force is terminated July 1, 2013.
1875 Section 35. Except as otherwise expressly provided in this
1876 act, this act shall take effect July 1, 2012.
1877
1878 ================= T I T L E A M E N D M E N T ================
1879 And the title is amended as follows:
1880 Delete everything before the enacting clause
1881 and insert:
1882 A bill to be entitled
1883 An act relating to assisted living facilities;
1884 amending s. 394.4574, F.S.; revising the duties of the
1885 case manager for, and requirements relating to the
1886 cooperative agreement and the community living support
1887 plan of, a mental health resident of an assisted
1888 living facility; amending s. 400.0078, F.S.; requiring
1889 that residents of long-term care facilities be
1890 informed about the confidentiality of the identity of
1891 the complainant of a complaint received by the State
1892 Long-Term Care Ombudsman Program; amending s.
1893 415.1034, F.S.; adding certain employees or agents of
1894 a state or local agency to the list of persons who
1895 must report the known or suspected abuse of a
1896 vulnerable adult to the abuse hotline; amending s.
1897 429.02, F.S.; providing definitions for “board” and
1898 “mental health surveyor”; amending s. 429.07, F.S.;
1899 authorizing the waiver of certain monitoring
1900 requirements under certain conditions; increasing the
1901 biennial license fee required for a facility that has
1902 certain violations within the 2 years preceding
1903 license renewal; amending s. 429.075, F.S.; revising
1904 the criteria preventing a licensed facility from
1905 receiving a limited mental health license; providing
1906 training requirements for administrators and staff
1907 members of facilities that hold a limited mental
1908 health license; requiring that a mental health
1909 surveyor be part of the team inspecting a facility
1910 that holds a limited mental health license; requiring
1911 semiannual monitoring of the facility; providing for
1912 an exception from semiannual monitoring; amending s.
1913 429.14, F.S.; revising the conditions for mandatory
1914 license denial or revocation; requiring the revocation
1915 of a facility license for certain violations that
1916 result in the death of a resident; amending s.
1917 429.176, F.S.; requiring the licensure of facility
1918 administrators; authorizing one administrator for
1919 multiple facilities under certain conditions;
1920 authorizing qualified facility managers during the
1921 temporary absence of an administrator; amending s.
1922 429.178, F.S.; revising training requirements for
1923 staff who provide care for persons who have
1924 Alzheimer’s disease and related disorders; amending s.
1925 429.19, F.S.; conforming provisions to changes made by
1926 the act; authorizing the Agency for Health Care
1927 Administration to impose certain citations and fines
1928 regardless of correction of a violation, an increased
1929 fine for certain violations that result in the death
1930 of a resident, and enhanced fines; creating s.
1931 429.231, F.S.; creating an advisory council to review
1932 unexpected deaths and elopements; providing for
1933 membership and duties; amending s. 429.28, F.S.;
1934 authorizing a resident to file a grievance with a
1935 facility when a notice of relocation or termination of
1936 residency has been received; requiring residents of
1937 facilities to be informed about the confidentiality of
1938 the identity of the resident and complainant of a
1939 complaint made to the State Long-Term Care Ombudsman
1940 Program; requiring the agency to conduct followup
1941 inspections of facilities that have a history of
1942 certain violations; providing that a facility that
1943 terminates an individual’s residency will be fined if
1944 good cause is not shown in court; creating s. 429.281,
1945 F.S.; establishing procedures for a resident grievance
1946 process upon notification of resident relocation or
1947 termination of residency; amending s. 429.34, F.S.;
1948 providing that the agency is designated as the central
1949 agency for tracking facility complaints; specifying
1950 timeframes for other state agencies to submit reports
1951 to the agency; requiring the agency to have lead
1952 surveyors who specialize in assessing facilities;
1953 amending s. 429.41, F.S.; requiring the agency to
1954 observe the elopement drills of a randomly selected
1955 group of facilities; requiring the agency to conduct
1956 an abbreviated biennial licensure inspection; amending
1957 s. 429.49, F.S.; increasing the criminal penalty for
1958 altering facility records; creating s. 429.515, F.S.;
1959 requiring new facility employees to attend a
1960 preservice orientation; providing requirements for
1961 such orientation; amending s. 429.52, F.S.; revising
1962 training, examination, and continuing education
1963 requirements for facility staff, including
1964 administrators; providing for the use of interactive
1965 online tutorials; requiring the Department of Elderly
1966 Affairs to develop training, examinations, and
1967 tutorials; creating s. 429.522, F.S.; requiring
1968 training providers to be certified by the Department
1969 of Elderly Affairs and provide trainer oversight;
1970 providing trainer requirements; requiring the
1971 department to maintain an electronic database of
1972 certified providers and persons who complete training
1973 if funding is available; amending s. 429.54, F.S.;
1974 requiring specified state agencies to have an
1975 electronic system of communication pertaining to the
1976 regulation of facilities; requiring facilities to
1977 submit certain facility and resident information
1978 electronically to the agency twice yearly; providing
1979 for the maintenance and use of such information;
1980 providing for expiration of this requirement; creating
1981 s. 429.55, F.S.; directing the agency to establish an
1982 online, user-friendly facility rating system that may
1983 be accessed by the public; providing a directive to
1984 the Division of Statutory Revision; amending s.
1985 468.1635, F.S.; revising the purpose of part II of ch.
1986 468, F.S., to include assisted living administrators;
1987 amending s. 468.1645, F.S.; requiring assisted living
1988 facilities to be operated under the management of a
1989 licensed administrator; amending s. 468.1655, F.S.;
1990 revising and providing definitions; amending s.
1991 468.1665, F.S.; renaming the Board of Nursing Home
1992 Administrators as the “Board of Long-Term Care
1993 Administrators”; providing for membership; prohibiting
1994 certain conflicts of interest with respect to board
1995 members; amending s. 468.1685, F.S.; revising duties
1996 of the board to include approving third-party
1997 credentialing entities for the purpose of an assisted
1998 living facility administrator certification program;
1999 amending s. 468.1695, F.S.; providing for licensure of
2000 assisted living facility administrators through
2001 certification; providing licensure requirements;
2002 establishing a maximum fee; amending s. 468.1705,
2003 F.S., relating to licensure by endorsement; conforming
2004 provisions to changes made by the act; amending s.
2005 468.1745, F.S.; providing requirements for who must be
2006 licensed as an assisted living facility administrator;
2007 amending s. 468.1755, F.S.; conforming provisions to
2008 changes made by the act; providing grounds for
2009 disciplinary action for assisted living facility
2010 administrators; amending s. 468.1756, F.S.; conforming
2011 provisions to changes made by the act; requiring the
2012 agency to create a task force to determine whether
2013 state agencies have overlapping regulatory
2014 jurisdiction over facilities and to submit findings
2015 and recommendations to the Governor and Legislature by
2016 a certain date; providing for termination; requiring
2017 the Office of the State Long-Term Care Ombudsman to
2018 create a task force to review the agency’s facility
2019 inspection forms and to submit its recommendations to
2020 the agency by a certain date; providing for
2021 termination; providing effective dates.