Florida Senate - 2013                          SENATOR AMENDMENT
       Bill No. CS/CS/HB 1159, 1st Eng.
                                Barcode 566056                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 1/RE/3R         .                                
             05/03/2013 11:10 AM       .                                

       Senator Hays moved the following:
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (a) of subsection (7) and subsection
    6  (14) of section 395.4001, Florida Statutes, are amended to read:
    7         395.4001 Definitions.—As used in this part, the term:
    8         (7) “Level II trauma center” means a trauma center that:
    9         (a) Is verified by the department to be in substantial
   10  compliance with Level II trauma center standards and has been
   11  approved by the department to operate as a Level II trauma
   12  center or is designated pursuant to s. 395.4025(14).
   13         (14) “Trauma center” means a hospital that has been
   14  verified by the department to be in substantial compliance with
   15  the requirements in s. 395.4025 and has been approved by the
   16  department to operate as a Level I trauma center, Level II
   17  trauma center, or pediatric trauma center, or is designated by
   18  the department as a Level II trauma center pursuant to
   19  s. 395.4025(14).
   20         Section 2. Paragraph (k) of subsection (1) of section
   21  395.401, Florida Statutes, is amended to read:
   22         395.401 Trauma services system plans; approval of trauma
   23  centers and pediatric trauma centers; procedures; renewal.—
   24         (1)
   25         (k) It is unlawful for any hospital or other facility to
   26  hold itself out as a trauma center unless it has been so
   27  verified or designated pursuant to s. 395.4025(14).
   28         Section 3. Subsection (14) of section 395.4025, Florida
   29  Statutes, is amended to read:
   30         395.4025 Trauma centers; selection; quality assurance;
   31  records.—
   32         (14) Notwithstanding the procedures established pursuant to
   33  subsections (1) through (13) in this section, hospitals located
   34  in areas with limited access to trauma center services shall be
   35  designated by the department as Level II trauma centers based on
   36  documentation of a valid certificate of trauma center
   37  verification from the American College of Surgeons. Areas with
   38  limited access to trauma center services are defined by the
   39  following criteria:
   40         (a)The hospital is located in a trauma service area with a
   41  population greater than 600,000 persons but a population density
   42  of less than 225 persons per square mile; and
   43         (b)The hospital is located in a county with no verified
   44  trauma center; and
   45  (c)The hospital is located at least 15 miles or 20 minutes
   46  travel time by ground transport from the nearest verified trauma
   47  center any other provisions of this section and rules adopted
   48  pursuant to this section, until the department has conducted the
   49  review provided under s. 395.402, only hospitals located in
   50  trauma services areas where there is no existing trauma center
   51  may apply.
   52         Section 4. Subsection (2) of section 408.036, Florida
   53  Statutes, is amended to read:
   54         408.036 Projects subject to review; exemptions.—
   55         (2) PROJECTS SUBJECT TO EXPEDITED REVIEW.—Unless exempt
   56  pursuant to subsection (3), projects subject to an expedited
   57  review shall include, but not be limited to:
   58         (a) A transfer of a certificate of need, except that when
   59  an existing hospital is acquired by a purchaser, all
   60  certificates of need issued to the hospital which are not yet
   61  operational shall be acquired by the purchaser, without need for
   62  a transfer.
   63         (b) Replacement of a nursing home within the same district,
   64  if the proposed project site is located within a geographic area
   65  that contains at least 65 percent of the facility’s current
   66  residents and is within a 30-mile radius of the replaced nursing
   67  home.
   68         (c) Relocation of a portion of a nursing home’s licensed
   69  beds to a facility within the same district, if the relocation
   70  is within a 30-mile radius of the existing facility and the
   71  total number of nursing home beds in the district does not
   72  increase.
   73         (d) The new construction of a community nursing home in a
   74  retirement community as further provided in this paragraph.
   75         1. Expedited review under this paragraph is available if
   76  all of the following criteria are met:
   77         a. The residential use area of the retirement community is
   78  deed-restricted as housing for older persons as defined in s.
   79  760.29(4)(b).
   80         b. The retirement community is located in a county in which
   81  25 percent or more of its population is age 65 and older.
   82         c. The retirement community is located in a county that has
   83  a rate of no more than 16.1 beds per 1,000 persons age 65 years
   84  or older. The rate shall be determined by using the current
   85  number of licensed and approved community nursing home beds in
   86  the county per the agency’s most recent published inventory.
   87         d. The retirement community has a population of at least
   88  8,000 residents within the county, based on a population data
   89  source accepted by the agency.
   90         e. The number of proposed community nursing home beds in an
   91  application does not exceed the projected bed need after
   92  applying the rate of 16.1 beds per 1,000 persons aged 65 years
   93  and older projected for the county 3 years into the future using
   94  the estimates adopted by the agency, after subtracting the
   95  inventory of licensed and approved community nursing home beds
   96  in the county per the agency’s most recent published inventory.
   97         2. No more than 120 community nursing home beds shall be
   98  approved for a qualified retirement community under each request
   99  for application for expedited review. Subsequent requests for
  100  expedited review under this process shall not be made until 2
  101  years after construction of the facility has commenced or 1 year
  102  after the beds approved through the initial request are
  103  licensed, whichever occurs first.
  104         3. The total number of community nursing home beds which
  105  may be approved for any single deed-restricted community
  106  pursuant to this paragraph shall not exceed 240, regardless of
  107  whether the retirement community is located in more than one
  108  qualifying county.
  109         4. Each nursing home facility approved under this paragraph
  110  shall be dually certified for participation in the Medicare and
  111  Medicaid programs.
  112         5. Each nursing home facility approved under this paragraph
  113  shall be at least one mile from an existing approved and
  114  licensed community nursing home, measured over publicly owned
  115  roadways.
  116         6. Section 408.0435 does not apply to this paragraph.
  117         7. A retirement community requesting expedited review under
  118  this paragraph shall submit a written request to the agency for
  119  an expedited review. The request shall include the number of
  120  beds to be added and provide evidence of compliance with the
  121  criteria specified in subparagraph 1.
  122         8. After verifying that the retirement community meets the
  123  criteria for expedited review specified in subparagraph 1., the
  124  agency shall publicly notice in the Florida Administrative
  125  Register that a request for an expedited review has been
  126  submitted by a qualifying retirement community and that the
  127  qualifying retirement community intends to make land available
  128  for the construction and operation of a community nursing home.
  129  The agency’s notice shall identify where potential applicants
  130  can obtain information describing sales price of, or terms of
  131  the land lease for, the property on which the project will be
  132  located and the requirements established by the retirement
  133  community. The agency notice shall also specify the deadline for
  134  submission of any certificate-of-need application, which shall
  135  not be earlier than the 91st day and not be later than the 125th
  136  day after the date the notice appears in the Florida
  137  Administrative Register.
  138         9. The qualified retirement community shall make land
  139  available to applicants it deems to have met its requirements
  140  for the construction and operation of a community nursing home
  141  but will sell or lease the land only to the applicant that is
  142  issued a certificate of need by the agency under the provisions
  143  of this paragraph.
  144         a. A certificate of need application submitted pursuant to
  145  this paragraph shall identify the intended site for the project
  146  within the retirement community and the anticipated costs for
  147  the project based on that site. The application shall also
  148  include written evidence that the retirement community has
  149  determined that the provider submitting the application and the
  150  project proposed by that provider satisfies its requirements for
  151  the project.
  152         b. The retirement community’s determination that more than
  153  one provider satisfies its requirements for the project does not
  154  preclude the retirement community from notifying the agency of
  155  the provider it prefers.
  156         10. Each application submitted shall be reviewed by the
  157  agency. If multiple applications are submitted for the project
  158  as published pursuant to subparagraph 8. above, then the
  159  competing applications shall be reviewed by the agency.
  161  The agency shall develop rules to implement the provisions for
  162  expedited review, including time schedule, application content
  163  which may be reduced from the full requirements of s.
  164  408.037(1), and application processing.
  165         Section 5. This act shall take effect upon becoming a law.
  168  ================= T I T L E  A M E N D M E N T ================
  169         And the title is amended as follows:
  170         Delete everything before the enacting clause
  171  and insert:
  172                        A bill to be entitled                      
  173         An act relating to health care facilities;
  174         amending s. 395.4001, F.S.; revising the definition of
  175         the terms “level II trauma center” and “trauma
  176         center”; amending s. 395.401, F.S.; making conforming
  177         changes; amending s. 395.4025, F.S.; establishing
  178         criteria for designating Level II trauma centers in
  179         areas with limited access to trauma center services;
  180         amending s. 408.036, F.S.; providing for expedited
  181         review of certificate-of-need for licensed skilled
  182         nursing facilities in qualifying retirement
  183         communities; providing criteria for expedited review
  184         for licensed skilled nursing homes in qualifying
  185         retirement communities; limiting the number of beds
  186         per retirement community that can be added through
  187         expedited review; providing an effective date.