Florida Senate - 2013 SENATOR AMENDMENT
Bill No. CS for CS for SB 1384
Barcode 345052
LEGISLATIVE ACTION
Senate . House
.
.
.
.
.
—————————————————————————————————————————————————————————————————
—————————————————————————————————————————————————————————————————
Senator Joyner moved the following:
1 Senate Amendment (with title amendment)
2
3 Between lines 96 and 97
4 insert:
5 Section 2. Subsection (3) of section 400.23, Florida
6 Statutes, is amended to read:
7 400.23 Rules; evaluation and deficiencies; licensure
8 status.—
9 (3)(a)1. The agency shall adopt rules providing minimum
10 staffing requirements for nursing home facilities. These
11 requirements must include, for each facility:
12 a. A minimum certified nursing assistant staffing of 2.9
13 hours of direct care per resident per day. A facility may not
14 staff below one certified nursing assistant per 20 residents. A
15 minimum weekly average of certified nursing assistant and
16 licensed nursing staffing combined of 3.6 hours of direct care
17 per resident per day. As used in this sub-subparagraph, a week
18 is defined as Sunday through Saturday.
19 b. A minimum licensed nursing staffing of 1.0 hour of
20 direct care per resident per day. A facility may not staff below
21 one licensed nurse per 40 residents. A minimum certified nursing
22 assistant staffing of 2.5 hours of direct care per resident per
23 day. A facility may not staff below one certified nursing
24 assistant per 20 residents.
25 c. A minimum licensed nursing staffing of 1.0 hour of
26 direct care per resident per day. A facility may not staff below
27 one licensed nurse per 40 residents.
28 2. A Nursing assistant assistants employed under s.
29 400.211(2) may be included in computing the staffing ratio for
30 certified nursing assistants if their job responsibilities
31 include only nursing-assistant-related duties.
32 3. Each nursing home facility must document compliance with
33 staffing standards as required under this paragraph and post
34 daily the names of staff on duty for the benefit of facility
35 residents and the public.
36 4. The agency shall recognize the use of licensed nurses
37 for compliance with minimum staffing requirements for certified
38 nursing assistants if the nursing home facility otherwise meets
39 the minimum staffing requirements for licensed nurses and the
40 licensed nurses are performing the duties of a certified nursing
41 assistant. Unless otherwise approved by the agency, licensed
42 nurses counted toward the minimum staffing requirements for
43 certified nursing assistants must exclusively perform the duties
44 of a certified nursing assistant for the entire shift and not
45 also be counted toward the minimum staffing requirements for
46 licensed nurses. If the agency approved a facility’s request to
47 use a licensed nurse to perform both licensed nursing and
48 certified nursing assistant duties, the facility must allocate
49 the amount of staff time specifically spent on certified nursing
50 assistant duties for the purpose of documenting compliance with
51 minimum staffing requirements for certified and licensed nursing
52 staff. The hours of a licensed nurse with dual job
53 responsibilities may not be counted twice.
54 (b) Nonnursing staff providing eating assistance to
55 residents do shall not count toward compliance with minimum
56 staffing standards.
57 (c) Licensed practical nurses licensed under chapter 464
58 who are providing nursing services in nursing home facilities
59 under this part may supervise the activities of other licensed
60 practical nurses, certified nursing assistants, and other
61 unlicensed personnel providing services in such facilities in
62 accordance with rules adopted by the Board of Nursing.
63 Section 3. For the purpose of incorporating the amendment
64 made by this act to section 400.23, Florida Statutes, in a
65 reference thereto, paragraphs (g) and (n) of subsection (1) of
66 section 400.141, Florida Statutes, are reenacted, and paragraph
67 (n) of subsection (1) of that section is amended, to read:
68 400.141 Administration and management of nursing home
69 facilities.—
70 (1) Every licensed facility shall comply with all
71 applicable standards and rules of the agency and shall:
72 (g) If the facility has a standard license, exceeds the
73 minimum required hours of licensed nursing and certified nursing
74 assistant direct care per resident per day, and is part of a
75 continuing care facility licensed under chapter 651 or a
76 retirement community that offers other services pursuant to part
77 III of this chapter or part I or part III of chapter 429 on a
78 single campus, be allowed to share programming and staff. At the
79 time of inspection, a continuing care facility or retirement
80 community that uses this option must demonstrate through
81 staffing records that minimum staffing requirements for the
82 facility were met. Licensed nurses and certified nursing
83 assistants who work in the facility may be used to provide
84 services elsewhere on campus if the facility exceeds the minimum
85 number of direct care hours required per resident per day and
86 the total number of residents receiving direct care services
87 from a licensed nurse or a certified nursing assistant does not
88 cause the facility to violate the staffing ratios required under
89 s. 400.23(3)(a). Compliance with the minimum staffing ratios
90 must be based on the total number of residents receiving direct
91 care services, regardless of where they reside on campus. If the
92 facility receives a conditional license, it may not share staff
93 until the conditional license status ends. This paragraph does
94 not restrict the agency’s authority under federal or state law
95 to require additional staff if a facility is cited for
96 deficiencies in care which are caused by an insufficient number
97 of certified nursing assistants or licensed nurses. The agency
98 may adopt rules for the documentation necessary to determine
99 compliance with this provision.
100 (n) Comply with state minimum-staffing requirements:
101 1. A facility that has failed to comply with state minimum
102 staffing requirements for 2 consecutive days is prohibited from
103 accepting new admissions until the facility has achieved the
104 minimum-staffing requirements for 6 consecutive days. For the
105 purposes of this subparagraph, any person who was a resident of
106 the facility and was absent from the facility for the purpose of
107 receiving medical care at a separate location or was on a leave
108 of absence is not considered a new admission. Failure by the
109 facility to impose such an admissions moratorium is subject to a
110 $1,000 fine.
111 2. A facility that does not have a conditional license may
112 be cited for failure to comply with the standards in s.
113 400.23(3)(a)1.b. and c. only if it has failed to meet those
114 standards on 2 consecutive days or if it has failed to meet at
115 least 97 percent of those standards on any one day.
116 3. A facility that has a conditional license must be in
117 compliance with the standards in s. 400.23(3)(a) at all times.
118
119 ================= T I T L E A M E N D M E N T ================
120 And the title is amended as follows:
121 Delete line 24
122 and insert:
123 damages; amending s. 400.23, F.S.; revising minimum
124 staffing requirements for nursing homes; reenacting
125 and amending s. 400.141(1)(g) and (1)(n), F.S.,
126 relating to the administration and management of
127 nursing home facilities, to incorporate the amendment
128 made to s. 400.23, F.S., in a reference thereto;
129 providing an effective date.