Florida Senate - 2014 SENATOR AMENDMENT
Bill No. CS/HB 7105, 1st Eng.
Senate . House
Floor: 10/RE/3R .
05/01/2014 08:06 PM .
Senator Sobel moved the following:
1 Senate Amendment (with title amendment)
3 Between lines 1104 and 1105
5 Section 27. Section 394.4574, Florida Statutes, is amended
6 to read:
Department Responsibilities for coordination of
8 services for a mental health resident who resides in an assisted
9 living facility that holds a limited mental health license.—
10 (1) As used in this section, the term “mental health
11 resident” “mental health resident,” for purposes of this
12 section, means an individual who receives social security
13 disability income due to a mental disorder as determined by the
14 Social Security Administration or receives supplemental security
15 income due to a mental disorder as determined by the Social
16 Security Administration and receives optional state
18 (2) Medicaid managed care plans are responsible for
19 Medicaid-enrolled mental health residents, and managing entities
20 under contract with the department are responsible for mental
21 health residents who are not enrolled in a Medicaid health plan.
22 A Medicaid managed care plan or a managing entity, as
23 appropriate, shall The department must ensure that:
24 (a) A mental health resident has been assessed by a
25 psychiatrist, clinical psychologist, clinical social worker, or
26 psychiatric nurse, or an individual who is supervised by one of
27 these professionals, and determined to be appropriate to reside
28 in an assisted living facility. The documentation must be
29 provided to the administrator of the facility within 30 days
30 after the mental health resident has been admitted to the
31 facility. An evaluation completed upon discharge from a state
32 mental hospital meets the requirements of this subsection
33 related to appropriateness for placement as a mental health
34 resident if it was completed within 90 days before prior to
35 admission to the facility.
36 (b) A cooperative agreement, as required in s. 429.075, is
37 developed by between the mental health care services provider
38 that serves a mental health resident and the administrator of
39 the assisted living facility with a limited mental health
40 license in which the mental health resident is living. 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 his or
51 her a mental health case manager of that resident in
52 consultation with the administrator of the facility or the
53 administrator’s designee. The plan must be completed and
54 provided to the administrator of the assisted living facility
55 with a limited mental health license in which the mental health
56 resident lives within 30 days after the resident’s admission.
57 The support plan and the agreement may be in one document.
58 (d) The assisted living facility with a limited mental
59 health license is provided with documentation that the
60 individual meets the definition of a mental health resident.
61 (e) The mental health services provider assigns a case
62 manager to each mental health resident for whom the entity is
63 responsible who lives in an assisted living facility with a
64 limited mental health license. The case manager shall coordinate
65 is responsible for coordinating the development of and
66 implementation of the community living support plan defined in
67 s. 429.02. The plan must be updated at least annually, or when
68 there is a significant change in the resident’s behavioral
69 health status, such as an inpatient admission or a change in
70 medication, level of service, or residence. Each case manager
71 shall keep a record of the date and time of any face-to-face
72 interaction with the resident and make the record available to
73 the responsible entity for inspection. The record must be
74 retained for at least 2 years after the date of the most recent
76 (f) Adequate and consistent monitoring and enforcement of
77 community living support plans and cooperative agreements are
78 conducted by the resident’s case manager.
79 (g) Concerns are reported to the appropriate regulatory
80 oversight organization if a regulated provider fails to deliver
81 appropriate services or otherwise acts in a manner that has the
82 potential to result in harm to the resident.
83 (3) The Secretary of Children and Families Family Services,
84 in consultation with the Agency for Health Care Administration,
85 shall annually require each district administrator to develop,
86 with community input, a detailed annual plan that demonstrates
87 detailed plans that demonstrate how the district will ensure the
88 provision of state-funded mental health and substance abuse
89 treatment services to residents of assisted living facilities
90 that hold a limited mental health license. This plan These plans
91 must be consistent with the substance abuse and mental health
92 district plan developed pursuant to s. 394.75 and must address
93 case management services; access to consumer-operated drop-in
94 centers; access to services during evenings, weekends, and
95 holidays; supervision of the clinical needs of the residents;
96 and access to emergency psychiatric care.
97 Section 28. Subsection (1) of section 400.0074, Florida
98 Statutes, is amended, and paragraph (h) is added to subsection
99 (2) of that section, to read:
100 400.0074 Local ombudsman council onsite administrative
102 (1) In addition to any specific investigation conducted
103 pursuant to a complaint, the local council shall conduct, at
104 least annually, an onsite administrative assessment of each
105 nursing home, assisted living facility, and adult family-care
106 home within its jurisdiction. This administrative assessment
107 must be comprehensive in nature and must shall focus on factors
108 affecting residents’ the rights, health, safety, and welfare of
109 the residents. Each local council is encouraged to conduct a
110 similar onsite administrative assessment of each additional
111 long-term care facility within its jurisdiction.
112 (2) An onsite administrative assessment conducted by a
113 local council shall be subject to the following conditions:
114 (h) The local council shall conduct an exit consultation
115 with the facility administrator or administrator designee to
116 discuss issues and concerns in areas affecting residents’
117 rights, health, safety, and welfare and, if needed, make
118 recommendations for improvement.
119 Section 29. Subsection (2) of section 400.0078, Florida
120 Statutes, is amended to read:
121 400.0078 Citizen access to State Long-Term Care Ombudsman
122 Program services.—
123 (2) Every resident or representative of a resident shall
124 receive, Upon admission to a long-term care facility, each
125 resident or representative of a resident must receive
126 information regarding the purpose of the State Long-Term Care
127 Ombudsman Program, the statewide toll-free telephone number for
128 receiving complaints, information that retaliatory action cannot
129 be taken against a resident for presenting grievances or for
130 exercising any other resident right, and other relevant
131 information regarding how to contact the program. Each resident
132 or his or her representative Residents or their representatives
133 must be furnished additional copies of this information upon
135 Section 30. Paragraph (c) of subsection (4) of section
136 409.212, Florida Statutes, is amended to read:
137 409.212 Optional supplementation.—
138 (4) In addition to the amount of optional supplementation
139 provided by the state, a person may receive additional
140 supplementation from third parties to contribute to his or her
141 cost of care. Additional supplementation may be provided under
142 the following conditions:
143 (c) The additional supplementation shall not exceed four
144 two times the provider rate recognized under the optional state
145 supplementation program.
146 Section 31. Paragraphs (b) and (c) of subsection (3) of
147 section 429.07, Florida Statutes, are amended to read:
148 429.07 License required; fee.—
149 (3) In addition to the requirements of s. 408.806, each
150 license granted by the agency must state the type of care for
151 which the license is granted. Licenses shall be issued for one
152 or more of the following categories of care: standard, extended
153 congregate care, limited nursing services, or limited mental
155 (b) An extended congregate care license shall be issued to
156 each facility that has been licensed as an assisted living
157 facility for 2 or more years and that provides services
158 facilities providing, directly or through contract, services
159 beyond those authorized in paragraph (a), including services
160 performed by persons licensed under part I of chapter 464 and
161 supportive services, as defined by rule, to persons who would
162 otherwise be disqualified from continued residence in a facility
163 licensed under this part. An extended congregate care license
164 may be issued to a facility that has a provisional extended
165 congregate care license and meets the requirements for licensure
166 under subparagraph 2. The primary purpose of extended congregate
167 care services is to allow residents the option of remaining in a
168 familiar setting from which they would otherwise be disqualified
169 for continued residency as they become more impaired. A facility
170 licensed to provide extended congregate care services may also
171 admit an individual who exceeds the admission criteria for a
172 facility with a standard license, if he or she is determined
173 appropriate for admission to the extended congregate care
175 1. In order for extended congregate care services to be
176 provided, the agency must first determine that all requirements
177 established in law and rule are met and must specifically
178 designate, on the facility’s license, that such services may be
179 provided and whether the designation applies to all or part of
180 the facility. This Such designation may be made at the time of
181 initial licensure or licensure renewal relicensure, or upon
182 request in writing by a licensee under this part and part II of
183 chapter 408. The notification of approval or the denial of the
184 request shall be made in accordance with part II of chapter 408.
185 Each existing facility that qualifies facilities qualifying to
186 provide extended congregate care services must have maintained a
187 standard license and may not have been subject to administrative
188 sanctions during the previous 2 years, or since initial
189 licensure if the facility has been licensed for less than 2
190 years, for any of the following reasons:
191 a. A class I or class II violation;
192 b. Three or more repeat or recurring class III violations
193 of identical or similar resident care standards from which a
194 pattern of noncompliance is found by the agency;
195 c. Three or more class III violations that were not
196 corrected in accordance with the corrective action plan approved
197 by the agency;
198 d. Violation of resident care standards which results in
199 requiring the facility to employ the services of a consultant
200 pharmacist or consultant dietitian;
201 e. Denial, suspension, or revocation of a license for
202 another facility licensed under this part in which the applicant
203 for an extended congregate care license has at least 25 percent
204 ownership interest; or
205 f. Imposition of a moratorium pursuant to this part or part
206 II of chapter 408 or initiation of injunctive proceedings.
208 The agency may deny or revoke a facility’s extended congregate
209 care license for not meeting the criteria for an extended
210 congregate care license as provided in this subparagraph.
211 2. If an assisted living facility has been licensed for
212 less than 2 years, the initial extended congregate care license
213 must be provisional and may not exceed 6 months. Within the
214 first 3 months after the provisional license is issued, the
215 licensee shall notify the agency, in writing, when it has
216 admitted at least one extended congregate care resident, after
217 which an unannounced inspection shall be made to determine
218 compliance with requirements of an extended congregate care
219 license. Failure to admit an extended congregate care resident
220 within the first 3 months shall render the extended congregate
221 care license void. A licensee that has a provisional extended
222 congregate care license which demonstrates compliance with all
223 of the requirements of an extended congregate care license
224 during the inspection shall be issued an extended congregate
225 care license. In addition to sanctions authorized under this
226 part, if violations are found during the inspection and the
227 licensee fails to demonstrate compliance with all assisted
228 living requirements during a followup inspection, the licensee
229 shall immediately suspend extended congregate care services, and
230 the provisional extended congregate care license expires. The
231 agency may extend the provisional license for not more than 1
232 month in order to complete a followup visit.
233 3. 2. A facility that is licensed to provide extended
234 congregate care services shall maintain a written progress
235 report on each person who receives services which describes the
236 type, amount, duration, scope, and outcome of services that are
237 rendered and the general status of the resident’s health. A
238 registered nurse, or appropriate designee, representing the
239 agency shall visit the facility at least twice a year quarterly
240 to monitor residents who are receiving extended congregate care
241 services and to determine if the facility is in compliance with
242 this part, part II of chapter 408, and relevant rules. One of
243 the visits may be in conjunction with the regular survey. The
244 monitoring visits may be provided through contractual
245 arrangements with appropriate community agencies. A registered
246 nurse shall serve as part of the team that inspects the
247 facility. The agency may waive one of the required yearly
248 monitoring visits for a facility that has:
249 a. Held an extended congregate care license for at least 24
250 months; been licensed for at least 24 months to provide extended
251 congregate care services, if, during the inspection, the
252 registered nurse determines that extended congregate care
253 services are being provided appropriately, and if the facility
255 b. No class I or class II violations and no uncorrected
256 class III violations; and .
257 c. No ombudsman council complaints that resulted in a
258 citation for licensure The agency must first consult with the
259 long-term care ombudsman council for the area in which the
260 facility is located to determine if any complaints have been
261 made and substantiated about the quality of services or care.
262 The agency may not waive one of the required yearly monitoring
263 visits if complaints have been made and substantiated.
264 4. 3. A facility that is licensed to provide extended
265 congregate care services must:
266 a. Demonstrate the capability to meet unanticipated
267 resident service needs.
268 b. Offer a physical environment that promotes a homelike
269 setting, provides for resident privacy, promotes resident
270 independence, and allows sufficient congregate space as defined
271 by rule.
272 c. Have sufficient staff available, taking into account the
273 physical plant and firesafety features of the building, to
274 assist with the evacuation of residents in an emergency.
275 d. Adopt and follow policies and procedures that maximize
276 resident independence, dignity, choice, and decisionmaking to
277 permit residents to age in place, so that moves due to changes
278 in functional status are minimized or avoided.
279 e. Allow residents or, if applicable, a resident’s
280 representative, designee, surrogate, guardian, or attorney in
281 fact to make a variety of personal choices, participate in
282 developing service plans, and share responsibility in
284 f. Implement the concept of managed risk.
285 g. Provide, directly or through contract, the services of a
286 person licensed under part I of chapter 464.
287 h. In addition to the training mandated in s. 429.52,
288 provide specialized training as defined by rule for facility
290 5. 4. A facility that is licensed to provide extended
291 congregate care services is exempt from the criteria for
292 continued residency set forth in rules adopted under s. 429.41.
293 A licensed facility must adopt its own requirements within
294 guidelines for continued residency set forth by rule. However,
295 the facility may not serve residents who require 24-hour nursing
296 supervision. A licensed facility that provides extended
297 congregate care services must also provide each resident with a
298 written copy of facility policies governing admission and
300 5. The primary purpose of extended congregate care services
301 is to allow residents, as they become more impaired, the option
302 of remaining in a familiar setting from which they would
303 otherwise be disqualified for continued residency. A facility
304 licensed to provide extended congregate care services may also
305 admit an individual who exceeds the admission criteria for a
306 facility with a standard license, if the individual is
307 determined appropriate for admission to the extended congregate
308 care facility.
309 6. Before the admission of an individual to a facility
310 licensed to provide extended congregate care services, the
311 individual must undergo a medical examination as provided in s.
312 429.26(4) and the facility must develop a preliminary service
313 plan for the individual.
314 7. If When a facility can no longer provide or arrange for
315 services in accordance with the resident’s service plan and
316 needs and the facility’s policy, the facility must shall make
317 arrangements for relocating the person in accordance with s.
319 8. Failure to provide extended congregate care services may
320 result in denial of extended congregate care license renewal.
321 (c) A limited nursing services license shall be issued to a
322 facility that provides services beyond those authorized in
323 paragraph (a) and as specified in this paragraph.
324 1. In order for limited nursing services to be provided in
325 a facility licensed under this part, the agency must first
326 determine that all requirements established in law and rule are
327 met and must specifically designate, on the facility’s license,
328 that such services may be provided. This Such designation may be
329 made at the time of initial licensure or licensure renewal
330 relicensure, or upon request in writing by a licensee under this
331 part and part II of chapter 408. Notification of approval or
332 denial of such request shall be made in accordance with part II
333 of chapter 408. An existing facility that qualifies facilities
334 qualifying to provide limited nursing services must shall have
335 maintained a standard license and may not have been subject to
336 administrative sanctions that affect the health, safety, and
337 welfare of residents for the previous 2 years or since initial
338 licensure if the facility has been licensed for less than 2
340 2. A facility Facilities that is are licensed to provide
341 limited nursing services shall maintain a written progress
342 report on each person who receives such nursing services. The ,
343 which report must describe describes the type, amount, duration,
344 scope, and outcome of services that are rendered and the general
345 status of the resident’s health. A registered nurse representing
346 the agency shall visit the facility such facilities at least
347 annually twice a year to monitor residents who are receiving
348 limited nursing services and to determine if the facility is in
349 compliance with applicable provisions of this part, part II of
350 chapter 408, and related rules. The monitoring visits may be
351 provided through contractual arrangements with appropriate
352 community agencies. A registered nurse shall also serve as part
353 of the team that inspects such facility. Visits may be in
354 conjunction with other agency inspections. The agency may waive
355 the required yearly monitoring visit for a facility that has:
356 a. Had a limited nursing services license for at least 24
358 b. No class I or class II violations and no uncorrected
359 class III violations; and
360 c. No ombudsman council complaints that resulted in a
361 citation for licensure.
362 3. A person who receives limited nursing services under
363 this part must meet the admission criteria established by the
364 agency for assisted living facilities. When a resident no longer
365 meets the admission criteria for a facility licensed under this
366 part, arrangements for relocating the person shall be made in
367 accordance with s. 429.28(1)(k), unless the facility is licensed
368 to provide extended congregate care services.
369 Section 32. Section 429.075, Florida Statutes, is amended
370 to read:
371 429.075 Limited mental health license.—An assisted living
372 facility that serves one three or more mental health residents
373 must obtain a limited mental health license.
374 (1) To obtain a limited mental health license, a facility
375 must hold a standard license as an assisted living facility,
376 must not have any current uncorrected deficiencies or
377 violations, and must ensure that, within 6 months after
378 receiving a limited mental health license, the facility
379 administrator and the staff of the facility who are in direct
380 contact with mental health residents must complete training of
381 no less than 6 hours related to their duties. This Such
382 designation may be made at the time of initial licensure or
383 relicensure or upon request in writing by a licensee under this
384 part and part II of chapter 408. Notification of approval or
385 denial of such request shall be made in accordance with this
386 part, part II of chapter 408, and applicable rules. This
387 training must will be provided by or approved by the Department
388 of Children and Families Family Services.
389 (2) A facility that is Facilities licensed to provide
390 services to mental health residents must shall provide
391 appropriate supervision and staffing to provide for the health,
392 safety, and welfare of such residents.
393 (3) A facility that has a limited mental health license
395 (a) Have a copy of each mental health resident’s community
396 living support plan and the cooperative agreement with the
397 mental health care services provider or provide written evidence
398 that a request for the community living support plan and the
399 cooperative agreement was sent to the Medicaid managed care plan
400 or managing entity under contract with the Department of
401 Children and Families within 72 hours after admission. The
402 support plan and the agreement may be combined.
403 (b) Have documentation that is provided by the Department
404 of Children and Families Family Services that each mental health
405 resident has been assessed and determined to be able to live in
406 the community in an assisted living facility that has with a
407 limited mental health license or provide written evidence that a
408 request for documentation was sent to the Department of Children
409 and Families within 72 hours after admission.
410 (c) Make the community living support plan available for
411 inspection by the resident, the resident’s legal guardian or ,
412 the resident’s health care surrogate, and other individuals who
413 have a lawful basis for reviewing this document.
414 (d) Assist the mental health resident in carrying out the
415 activities identified in the individual’s community living
416 support plan.
417 (4) A facility that has with a limited mental health
418 license may enter into a cooperative agreement with a private
419 mental health provider. For purposes of the limited mental
420 health license, the private mental health provider may act as
421 the case manager.
422 Section 33. Section 429.14, Florida Statutes, is amended to
424 429.14 Administrative penalties.—
425 (1) In addition to the requirements of part II of chapter
426 408, the agency may deny, revoke, and suspend any license issued
427 under this part and impose an administrative fine in the manner
428 provided in chapter 120 against a licensee for a violation of
429 any provision of this part, part II of chapter 408, or
430 applicable rules, or for any of the following actions by a
431 licensee, for the actions of any person subject to level 2
432 background screening under s. 408.809, or for the actions of any
433 facility staff employee:
434 (a) An intentional or negligent act seriously affecting the
435 health, safety, or welfare of a resident of the facility.
436 (b) A The determination by the agency that the owner lacks
437 the financial ability to provide continuing adequate care to
439 (c) Misappropriation or conversion of the property of a
440 resident of the facility.
441 (d) Failure to follow the criteria and procedures provided
442 under part I of chapter 394 relating to the transportation,
443 voluntary admission, and involuntary examination of a facility
445 (e) A citation for of any of the following violations
446 deficiencies as specified in s. 429.19:
447 1. One or more cited class I violations deficiencies.
448 2. Three or more cited class II violations deficiencies.
449 3. Five or more cited class III violations deficiencies
450 that have been cited on a single survey and have not been
451 corrected within the times specified.
452 (f) Failure to comply with the background screening
453 standards of this part, s. 408.809(1), or chapter 435.
454 (g) Violation of a moratorium.
455 (h) Failure of the license applicant, the licensee during
456 licensure renewal relicensure, or a licensee that holds a
457 provisional license to meet the minimum license requirements of
458 this part, or related rules, at the time of license application
459 or renewal.
460 (i) An intentional or negligent life-threatening act in
461 violation of the uniform firesafety standards for assisted
462 living facilities or other firesafety standards which that
463 threatens the health, safety, or welfare of a resident of a
464 facility, as communicated to the agency by the local authority
465 having jurisdiction or the State Fire Marshal.
466 (j) Knowingly operating any unlicensed facility or
467 providing without a license any service that must be licensed
468 under this chapter or chapter 400.
469 (k) Any act constituting a ground upon which application
470 for a license may be denied.
471 (2) Upon notification by the local authority having
472 jurisdiction or by the State Fire Marshal, the agency may deny
473 or revoke the license of an assisted living facility that fails
474 to correct cited fire code violations that affect or threaten
475 the health, safety, or welfare of a resident of a facility.
476 (3) The agency may deny or revoke a license of an to any
477 applicant or controlling interest as defined in part II of
478 chapter 408 which has or had a 25 percent 25-percent or greater
479 financial or ownership interest in any other facility that is
480 licensed under this part, or in any entity licensed by this
481 state or another state to provide health or residential care, if
482 that which facility or entity during the 5 years before prior to
483 the application for a license closed due to financial inability
484 to operate; had a receiver appointed or a license denied,
485 suspended, or revoked; was subject to a moratorium; or had an
486 injunctive proceeding initiated against it.
487 (4) The agency shall deny or revoke the license of an
488 assisted living facility if:
489 (a) There are two moratoria, issued pursuant to this part
490 or part II of chapter 408, within a 2-year period which are
491 imposed by final order;
492 (b) The facility is cited for two or more class I
493 violations arising from unrelated circumstances during the same
494 survey or investigation; or
495 (c) The facility is cited for two or more class I
496 violations arising from separate surveys or investigations
497 within a 2-year period that has two or more class I violations
498 that are similar or identical to violations identified by the
499 agency during a survey, inspection, monitoring visit, or
500 complaint investigation occurring within the previous 2 years.
501 (5) An action taken by the agency to suspend, deny, or
502 revoke a facility’s license under this part or part II of
503 chapter 408, in which the agency claims that the facility owner
504 or an employee of the facility has threatened the health,
505 safety, or welfare of a resident of the facility, must be heard
506 by the Division of Administrative Hearings of the Department of
507 Management Services within 120 days after receipt of the
508 facility’s request for a hearing, unless that time limitation is
509 waived by both parties. The administrative law judge shall must
510 render a decision within 30 days after receipt of a proposed
511 recommended order.
512 (6) As provided under s. 408.814, the agency shall impose
513 an immediate moratorium on an assisted living facility that
514 fails to provide the agency access to the facility or prohibits
515 the agency from conducting a regulatory inspection. The licensee
516 may not restrict agency staff in accessing and copying records
517 or in conducting confidential interviews with facility staff or
518 any individual who receives services from the facility provide
519 to the Division of Hotels and Restaurants of the Department of
520 Business and Professional Regulation, on a monthly basis, a list
521 of those assisted living facilities that have had their licenses
522 denied, suspended, or revoked or that are involved in an
523 appellate proceeding pursuant to s. 120.60 related to the
524 denial, suspension, or revocation of a license.
525 (7) Agency notification of a license suspension or
526 revocation, or denial of a license renewal, shall be posted and
527 visible to the public at the facility.
528 (8) If a facility is required to relocate some or all of
529 its residents due to agency action, that facility is exempt from
530 the 45 days’ notice requirement imposed under s. 429.28(1)(k).
531 This subsection does not exempt the facility from any deadlines
532 for corrective action set by the agency.
533 Section 34. Paragraphs (a) and (b) of subsection (2) of
534 section 429.178, Florida Statutes, are amended to read:
535 429.178 Special care for persons with Alzheimer’s disease
536 or other related disorders.—
537 (2)(a) An individual who is employed by a facility that
538 provides special care for residents who have with Alzheimer’s
539 disease or other related disorders, and who has regular contact
540 with such residents, must complete up to 4 hours of initial
541 dementia-specific training developed or approved by the
542 department. The training must shall be completed within 3 months
543 after beginning employment and satisfy shall satisfy the core
544 training requirements of s. 429.52(3)(g) s. 429.52(2)(g).
545 (b) A direct caregiver who is employed by a facility that
546 provides special care for residents who have with Alzheimer’s
547 disease or other related disorders , and who provides direct care
548 to such residents , must complete the required initial training
549 and 4 additional hours of training developed or approved by the
550 department. The training must shall be completed within 9 months
551 after beginning employment and satisfy shall satisfy the core
552 training requirements of s. 429.52(3)(g) s. 429.52(2)(g).
553 Section 35. Section 429.19, Florida Statutes, is amended to
555 429.19 Violations; imposition of administrative fines;
557 (1) In addition to the requirements of part II of chapter
558 408, the agency shall impose an administrative fine in the
559 manner provided in chapter 120 for the violation of any
560 provision of this part, part II of chapter 408, and applicable
561 rules by an assisted living facility, for the actions of any
562 person subject to level 2 background screening under s. 408.809,
563 for the actions of any facility employee, or for an intentional
564 or negligent act seriously affecting the health, safety, or
565 welfare of a resident of the facility.
566 (2) Each violation of this part and adopted rules must
567 shall be classified according to the nature of the violation and
568 the gravity of its probable effect on facility residents. The
569 scope of a violation may be cited as an isolated, patterned, or
570 widespread deficiency. An isolated deficiency is a deficiency
571 affecting one or a very limited number of residents, or
572 involving one or a very limited number of staff, or a situation
573 that occurred only occasionally or in a very limited number of
574 locations. A patterned deficiency is a deficiency in which more
575 than a very limited number of residents are affected, or more
576 than a very limited number of staff are affected, or the
577 situation has occurred in several locations, or the same
578 resident or residents have been affected by repeated occurrences
579 of the same deficient practice but the effect of the deficient
580 practice is not found to be pervasive throughout the facility. A
581 widespread deficiency is a deficiency in which the problems
582 causing the deficiency are pervasive in the facility or
583 represent systemic failure that has affected or has the
584 potential to affect a large portion of the facility’s residents.
585 (a) The agency shall indicate the classification on the
586 written notice of the violation as follows:
587 1. (a) Class “I” violations are defined in s. 408.813. The
588 agency shall impose an administrative fine for a cited class I
589 violation of $5,000 for an isolated deficiency; $7,500 for a
590 patterned deficiency; and $10,000 for a widespread deficiency.
591 If the agency has knowledge of a class I violation that occurred
592 within 12 months before an inspection, a fine must be levied for
593 that violation, regardless of whether the noncompliance is
594 corrected before the inspection in an amount not less than
595 $5,000 and not exceeding $10,000 for each violation.
596 2. (b) Class “II” violations are defined in s. 408.813. The
597 agency shall impose an administrative fine for a cited class II
598 violation of $1,000 for an isolated deficiency; $3,000 for a
599 patterned deficiency; and $5,000 for a widespread deficiency in
600 an amount not less than $1,000 and not exceeding $5,000 for each
602 3. (c) Class “III” violations are defined in s. 408.813. The
603 agency shall impose an administrative fine for a cited class III
604 violation of $500 for an isolated deficiency; $750 for a
605 patterned deficiency; and $1,000 for a widespread deficiency in
606 an amount not less than $500 and not exceeding $1,000 for each
608 4. (d) Class “IV” violations are defined in s. 408.813. The
609 agency shall impose an administrative fine for a cited class IV
610 violation of $100 for an isolated deficiency; $150 for a
611 patterned deficiency; and $200 for a widespread deficiency in an
612 amount not less than $100 and not exceeding $200 for each
614 (b) Any fine imposed for a class I violation or a class II
615 violation must be doubled if a facility was previously cited for
616 one or more class I or class II violations during the agency’s
617 last licensure inspection or any inspection or complaint
618 investigation since the last licensure inspection.
619 (c) Notwithstanding s. 408.813(2)(c) and (d) and s.
620 408.832, a fine must be imposed for each class III or class IV
621 violation, regardless of correction, if a facility was
622 previously cited for one or more class III or class IV
623 violations during the agency’s last licensure inspection or any
624 inspection or complaint investigation since the last licensure
625 inspection for the same regulatory violation. A fine imposed for
626 class III or class IV violations must be doubled if a facility
627 was previously cited for one or more class III or class IV
628 violations during the agency’s last two licensure inspections
629 for the same regulatory violation.
630 (d) Notwithstanding the fine amounts specified in
631 subparagraphs (a)1.-4., and regardless of the class of violation
632 cited, the agency shall impose an administrative fine of $500 on
633 a facility that is found not to be in compliance with the
634 background screening requirements as provided in s. 408.809.
635 (3) For purposes of this section, in determining if a
636 penalty is to be imposed and in fixing the amount of the fine,
637 the agency shall consider the following factors:
638 (a) The gravity of the violation, including the probability
639 that death or serious physical or emotional harm to a resident
640 will result or has resulted, the severity of the action or
641 potential harm, and the extent to which the provisions of the
642 applicable laws or rules were violated.
643 (b) Actions taken by the owner or administrator to correct
645 (c) Any previous violations.
646 (d) The financial benefit to the facility of committing or
647 continuing the violation.
648 (e) The licensed capacity of the facility.
649 (3) (4) Each day of continuing violation after the date
650 established by the agency fixed for correction termination of
651 the violation , as ordered by the agency, constitutes an
652 additional, separate, and distinct violation.
653 (4) (5) An Any action taken to correct a violation shall be
654 documented in writing by the owner or administrator of the
655 facility and verified through followup visits by agency
656 personnel. The agency may impose a fine and, in the case of an
657 owner-operated facility, revoke or deny a facility’s license
658 when a facility administrator fraudulently misrepresents action
659 taken to correct a violation.
660 (5) (6) A Any facility whose owner fails to apply for a
661 change-of-ownership license in accordance with part II of
662 chapter 408 and operates the facility under the new ownership is
663 subject to a fine of $5,000.
664 (6) (7) In addition to any administrative fines imposed, the
665 agency may assess a survey fee, equal to the lesser of one half
666 of the facility’s biennial license and bed fee or $500, to cover
667 the cost of conducting initial complaint investigations that
668 result in the finding of a violation that was the subject of the
669 complaint or monitoring visits conducted under s. 429.28(3)(c)
670 to verify the correction of the violations.
671 (7) (8) During an inspection, the agency shall make a
672 reasonable attempt to discuss each violation with the owner or
673 administrator of the facility, before prior to written
675 (8) (9) The agency shall develop and disseminate an annual
676 list of all facilities sanctioned or fined for violations of
677 state standards, the number and class of violations involved,
678 the penalties imposed, and the current status of cases. The list
679 shall be disseminated, at no charge, to the Department of
680 Elderly Affairs, the Department of Health, the Department of
681 Children and Families Family Services, the Agency for Persons
682 with Disabilities, the area agencies on aging, the Florida
683 Statewide Advocacy Council, and the state and local ombudsman
684 councils. The Department of Children and Families Family
685 Services shall disseminate the list to service providers under
686 contract to the department who are responsible for referring
687 persons to a facility for residency. The agency may charge a fee
688 commensurate with the cost of printing and postage to other
689 interested parties requesting a copy of this list. This
690 information may be provided electronically or through the
691 agency’s website Internet site.
692 Section 36. Subsection (3) and paragraph (c) of subsection
693 (4) of section 429.256, Florida Statutes, are amended to read:
694 429.256 Assistance with self-administration of medication.—
695 (3) Assistance with self-administration of medication
697 (a) Taking the medication, in its previously dispensed,
698 properly labeled container, including an insulin syringe that is
699 prefilled with the proper dosage by a pharmacist and an insulin
700 pen that is prefilled by the manufacturer, from where it is
701 stored, and bringing it to the resident.
702 (b) In the presence of the resident, reading the label,
703 opening the container, removing a prescribed amount of
704 medication from the container, and closing the container.
705 (c) Placing an oral dosage in the resident’s hand or
706 placing the dosage in another container and helping the resident
707 by lifting the container to his or her mouth.
708 (d) Applying topical medications.
709 (e) Returning the medication container to proper storage.
710 (f) Keeping a record of when a resident receives assistance
711 with self-administration under this section.
712 (g) Assisting with the use of a nebulizer, including
713 removing the cap of a nebulizer, opening the unit dose of
714 nebulizer solution, and pouring the prescribed premeasured dose
715 of medication into the dispensing cup of the nebulizer.
716 (h) Using a glucometer to perform blood-glucose level
718 (i) Assisting with putting on and taking off antiembolism
720 (j) Assisting with applying and removing an oxygen cannula,
721 but not with titrating the prescribed oxygen settings.
722 (k) Assisting with the use of a continuous positive airway
723 pressure (CPAP) device, but not with titrating the prescribed
724 setting of the device.
725 (l) Assisting with measuring vital signs.
726 (m) Assisting with colostomy bags.
727 (4) Assistance with self-administration does not include:
728 (c) Administration of medications through intermittent
729 positive pressure breathing machines or a nebulizer.
730 Section 37. Subsections (2), (5), and (6) of section
731 429.28, Florida Statutes, are amended to read:
732 429.28 Resident bill of rights.—
733 (2) The administrator of a facility shall ensure that a
734 written notice of the rights, obligations, and prohibitions set
735 forth in this part is posted in a prominent place in each
736 facility and read or explained to residents who cannot read. The
737 This notice must shall include the name, address, and telephone
738 numbers of the local ombudsman council, the and central abuse
739 hotline, and, if when applicable, Disability Rights Florida the
740 Advocacy Center for Persons with Disabilities, Inc., and the
741 Florida local advocacy council, where complaints may be lodged.
742 The notice must state that a complaint made to the Office of
743 State Long-Term Care Ombudsman or a local long-term care
744 ombudsman council, the names and identities of the residents
745 involved in the complaint, and the identity of complainants are
746 kept confidential pursuant to s. 400.0077 and that retaliatory
747 action cannot be taken against a resident for presenting
748 grievances or for exercising any other resident right. The
749 facility must ensure a resident’s access to a telephone to call
750 the local ombudsman council, central abuse hotline, and
751 Disability Rights Florida Advocacy Center for Persons with
752 Disabilities, Inc., and the Florida local advocacy council.
753 (5) A No facility or employee of a facility may not serve
754 notice upon a resident to leave the premises or take any other
755 retaliatory action against any person who:
756 (a) Exercises any right set forth in this section.
757 (b) Appears as a witness in any hearing, inside or outside
758 the facility.
759 (c) Files a civil action alleging a violation of the
760 provisions of this part or notifies a state attorney or the
761 Attorney General of a possible violation of such provisions.
762 (6) A Any facility that which terminates the residency of
763 an individual who participated in activities specified in
764 subsection (5) must shall show good cause in a court of
765 competent jurisdiction. If good cause is not shown, the agency
766 shall impose a fine of $2,500 in addition to any other penalty
767 assessed against the facility.
768 Section 38. Section 429.34, Florida Statutes, is amended to
770 429.34 Right of entry and inspection.—
771 (1) In addition to the requirements of s. 408.811, any duly
772 designated officer or employee of the department, the Department
773 of Children and Families Family Services, the Medicaid Fraud
774 Control Unit of the Office of the Attorney General, the state or
775 local fire marshal, or a member of the state or local long-term
776 care ombudsman council has shall have the right to enter
777 unannounced upon and into the premises of any facility licensed
778 pursuant to this part in order to determine the state of
779 compliance with the provisions of this part, part II of chapter
780 408, and applicable rules. Data collected by the state or local
781 long-term care ombudsman councils or the state or local advocacy
782 councils may be used by the agency in investigations involving
783 violations of regulatory standards. A person specified in this
784 section who knows or has reasonable cause to suspect that a
785 vulnerable adult has been or is being abused, neglected, or
786 exploited shall immediately report such knowledge or suspicion
787 to the central abuse hotline pursuant to chapter 415.
788 (2) The agency shall inspect each licensed assisted living
789 facility at least once every 24 months to determine compliance
790 with this chapter and related rules. If an assisted living
791 facility is cited for one or more class I violations or two or
792 more class II violations arising from separate surveys within a
793 60-day period or due to unrelated circumstances during the same
794 survey, the agency must conduct an additional licensure
795 inspection within 6 months. In addition to any fines imposed on
796 the facility under s. 429.19, the licensee shall pay a fee for
797 the cost of the additional inspection equivalent to the standard
798 assisted living facility license and per-bed fees, without
799 exception for beds designated for recipients of optional state
800 supplementation. The agency shall adjust the fee in accordance
801 with s. 408.805.
802 Section 39. Subsection (2) of section 429.41, Florida
803 Statutes, is amended to read:
804 429.41 Rules establishing standards.—
805 (2) In adopting any rules pursuant to this part, the
806 department, in conjunction with the agency, shall make distinct
807 standards for facilities based upon facility size; the types of
808 care provided; the physical and mental capabilities and needs of
809 residents; the type, frequency, and amount of services and care
810 offered; and the staffing characteristics of the facility. Rules
811 developed pursuant to this section may shall not restrict the
812 use of shared staffing and shared programming in facilities that
813 are part of retirement communities that provide multiple levels
814 of care and otherwise meet the requirements of law and rule. If
815 a continuing care facility licensed under chapter 651 or a
816 retirement community offering multiple levels of care obtains a
817 license pursuant to this chapter for a building or part of a
818 building designated for independent living, staffing
819 requirements established in rule apply only to residents who
820 receive personal services, limited nursing services, or extended
821 congregate care services under this part. Such facilities shall
822 retain a log listing the names and unit number for residents
823 receiving these services. The log must be available to surveyors
824 upon request. Except for uniform firesafety standards, the
825 department shall adopt by rule separate and distinct standards
826 for facilities with 16 or fewer beds and for facilities with 17
827 or more beds. The standards for facilities with 16 or fewer beds
828 must shall be appropriate for a noninstitutional residential
829 environment; , however, provided that the structure may not be is
830 no more than two stories in height and all persons who cannot
831 exit the facility unassisted in an emergency must reside on the
832 first floor. The department, in conjunction with the agency, may
833 make other distinctions among types of facilities as necessary
834 to enforce the provisions of this part. Where appropriate, the
835 agency shall offer alternate solutions for complying with
836 established standards, based on distinctions made by the
837 department and the agency relative to the physical
838 characteristics of facilities and the types of care offered
840 Section 40. Present subsections (1) through (11) of section
841 429.52, Florida Statutes, are redesignated as subsections (2)
842 through (12), respectively, a new subsection (1) is added to
843 that section, and present subsections (5) and (9) of that
844 section are amended, to read:
845 429.52 Staff training and educational programs; core
846 educational requirement.—
847 (1) Effective October 1, 2014, each new assisted living
848 facility employee who has not previously completed core training
849 must attend a preservice orientation provided by the facility
850 before interacting with residents. The preservice orientation
851 must be at least 2 hours in duration and cover topics that help
852 the employee provide responsible care and respond to the needs
853 of facility residents. Upon completion, the employee and the
854 administrator of the facility must sign a statement that the
855 employee completed the required preservice orientation. The
856 facility must keep the signed statement in the employee’s
857 personnel record.
858 (6) (5) Staff involved with the management of medications
859 and assisting with the self-administration of medications under
860 s. 429.256 must complete a minimum of 6 4 additional hours of
861 training provided by a registered nurse, licensed pharmacist, or
862 department staff. The department shall establish by rule the
863 minimum requirements of this additional training.
864 (10) (9) The training required by this section other than
865 the preservice orientation must shall be conducted by persons
866 registered with the department as having the requisite
867 experience and credentials to conduct the training. A person
868 seeking to register as a trainer must provide the department
869 with proof of completion of the minimum core training education
870 requirements, successful passage of the competency test
871 established under this section, and proof of compliance with the
872 continuing education requirement in subsection (5) (4).
873 Section 41. The Legislature finds that consistent
874 regulation of assisted living facilities benefits residents and
875 operators of such facilities. To determine whether surveys are
876 consistent between surveys and surveyors, the Office of Program
877 Policy Analysis and Government Accountability (OPPAGA) shall
878 conduct a study of intersurveyor reliability for assisted living
879 facilities. By November 1, 2014, OPPAGA shall report its
880 findings to the Governor, the President of the Senate, and the
881 Speaker of the House of Representatives and make any
882 recommendations for improving intersurveyor reliability.
883 Section 42. Section 429.55, Florida Statutes, is created to
885 429.55 Public access to data; rating system and comment
887 (1) The Legislature finds that consumers need additional
888 information on the quality of care and service in assisted
889 living facilities in order to select the best facility for
890 themselves or their loved ones.
891 (2) By March 1, 2015, the agency shall implement a rating
892 system for assisted living facilities based on facility
893 inspections, violations, complaints, and agency visits to assist
894 consumers and residents. The agency may adopt rules to
895 administer this subsection.
896 (3) By November 1, 2014, the agency shall provide,
897 maintain, and update at least quarterly, electronically
898 accessible data on assisted living facilities. Such data must be
899 searchable, downloadable, and available in generally accepted
900 formats. At a minimum, such data must include:
901 (a) Information on each assisted living facility licensed
902 under this part, including:
903 1. The name and address of the facility.
904 2. The number and type of licensed beds in the facility.
905 3. The types of licenses held by the facility.
906 4. The facility’s license expiration date and status.
907 5. Proprietary or nonproprietary status of the licensee.
908 6. Any affiliation with a company or other organization
909 owning or managing more than one assisted living facility in
910 this state.
911 7. The total number of clients that the facility is
912 licensed to serve and the most recently available occupancy
914 8. The number of private and semiprivate rooms offered.
915 9. The bed-hold policy.
916 10. The religious affiliation, if any, of the assisted
917 living facility.
918 11. The languages spoken by the staff.
919 12. Availability of nurses.
920 13. Forms of payment accepted, including, but not limited
921 to, Medicaid, Medicaid long-term managed care, private
922 insurance, health maintenance organization, United States
923 Department of Veterans Affairs, CHAMPUS program, or workers’
924 compensation coverage.
925 14. Indication if the licensee is operating under
926 bankruptcy protection.
927 15. Recreational and other programs available.
928 16. Special care units or programs offered.
929 17. Whether the facility is a part of a retirement
930 community that offers other services pursuant to this part or
931 part III of this chapter, part II or part III of chapter 400, or
932 chapter 651.
933 18. Links to the State Long-Term Care Ombudsman Program
934 website and the program’s statewide toll-free telephone number.
935 19. Links to the websites of the providers or their
937 20. Other relevant information that the agency currently
939 (b) A list of the facility’s violations, including, for
940 each violation:
941 1. A summary of the violation presented in a manner
942 understandable by the general public;
943 2. Any sanctions imposed by final order; and
944 3. The date the corrective action was confirmed by the
946 (c) Links to inspection reports on file with the agency.
947 (4) The agency shall provide a monitored comment webpage
948 that allows members of the public to comment on specific
949 assisted living facilities licensed to operate in this state. At
950 a minimum, the comment webpage must allow members of the public
951 to identify themselves, provide comments on their experiences
952 with, or observations of, an assisted living facility, and view
953 others’ comments.
954 (a) The agency shall review comments for profanities and
955 redact any profanities before posting the comments to the
956 webpage. After redacting any profanities, the agency shall post
957 all comments, and shall retain all comments as they were
958 originally submitted, which are subject to the requirements of
959 chapter 119 and which shall be retained by the agency for
960 inspection by the public without further redaction pursuant to
961 retention schedules and disposal processes for such records.
962 (b) A controlling interest, as defined in s. 408.803 in an
963 assisted living facility, or an employee or owner of an assisted
964 living facility, is prohibited from posting comments on the
965 page. A controlling interest, employee, or owner may respond to
966 comments on the page, and the agency shall ensure that such
967 responses are identified as being from a representative of the
969 (5) The agency may provide links to third-party websites
970 that use the data published pursuant to this section to assist
971 consumers in evaluating the quality of care and service in
972 assisted living facilities.
973 Section 43. For the 2014-2015 fiscal year, the sums of
974 $156,943 in recurring funds and $7,546 in nonrecurring funds
975 from the Health Care Trust Fund and two full-time equivalent
976 senior attorney positions with associated salary rate of 103,652
977 are appropriated to the Agency for Health Care Administration
978 for the purpose of implementing the regulatory provisions of
979 this act.
980 Section 44. For the 2014-2015 fiscal year, for the purpose
981 of implementing and maintaining the public information website
982 enhancements provided under this act:
983 (1) The sums of $72,435 in recurring funds and $3,773 in
984 nonrecurring funds from the Health Care Trust Fund and one full
985 time equivalent health services and facilities consultant
986 position with associated salary rate of 46,560 are appropriated
987 to the Agency for Health Care Administration;
988 (2) The sums of $30,000 in recurring funds and $15,000 in
989 nonrecurring funds from the Health Care Trust Fund are
990 appropriated to the Agency for Health Care Administration for
991 software purchase, installation, and maintenance services; and
992 (3) The sums of $2,474 in recurring funds and $82,806 in
993 nonrecurring funds from the Health Care Trust Fund are
994 appropriated to the Agency for Health Care Administration for
995 contracted services.
997 ================= T I T L E A M E N D M E N T ================
998 And the title is amended as follows:
999 Delete line 78
1000 and insert:
1001 tissue donations; amending s. 394.4574, F.S.;
1002 providing that Medicaid managed care plans are
1003 responsible for enrolled mental health residents;
1004 providing that managing entities under contract with
1005 the Department of Children and Families are
1006 responsible for mental health residents who are not
1007 enrolled with a Medicaid managed care plan; deleting a
1008 provision to conform to changes made by the act;
1009 requiring that the community living support plan be
1010 completed and provided to the administrator of a
1011 facility after the mental health resident’s admission;
1012 requiring the community living support plan to be
1013 updated when there is a significant change to the
1014 mental health resident’s behavioral health; requiring
1015 the case manager assigned to a mental health resident
1016 of an assisted living facility that holds a limited
1017 mental health license to keep a record of the date and
1018 time of face-to-face interactions with the resident
1019 and to make the record available to the responsible
1020 entity for inspection; requiring that the record be
1021 maintained for a specified time; requiring the
1022 responsible entity to ensure that there is adequate
1023 and consistent monitoring and enforcement of community
1024 living support plans and cooperative agreements and
1025 that concerns are reported to the appropriate
1026 regulatory oversight organization under certain
1027 circumstances; amending s. 400.0074, F.S.; requiring
1028 that an administrative assessment conducted by a local
1029 council be comprehensive in nature and focus on
1030 factors affecting the rights, health, safety, and
1031 welfare of residents in the facilities; requiring a
1032 local council to conduct an exit consultation with the
1033 facility administrator or administrator designee to
1034 discuss issues and concerns in areas affecting the
1035 rights, health, safety, and welfare of residents and
1036 make recommendations for improvement; amending s.
1037 400.0078, F.S.; requiring that a resident or a
1038 representative of a resident of a long-term care
1039 facility be informed that retaliatory action cannot be
1040 taken against a resident for presenting grievances or
1041 for exercising any other resident right; amending s.
1042 409.212, F.S.; increasing the cap on additional
1043 supplementation a person may receive under certain
1044 conditions; amending s. 429.07, F.S.; revising the
1045 requirement that an extended congregate care license
1046 be issued to certain facilities that have been
1047 licensed as assisted living facilities under certain
1048 circumstances and authorizing the issuance of such
1049 license if a specified condition is met; providing the
1050 purpose of an extended congregate care license;
1051 providing that the initial extended congregate care
1052 license of an assisted living facility is provisional
1053 under certain circumstances; requiring a licensee to
1054 notify the Agency for Health Care Administration if it
1055 accepts a resident who qualifies for extended
1056 congregate care services; requiring the agency to
1057 inspect the facility for compliance with the
1058 requirements of an extended congregate care license;
1059 requiring the issuance of an extended congregate care
1060 license under certain circumstances; requiring the
1061 licensee to immediately suspend extended congregate
1062 care services under certain circumstances; requiring a
1063 registered nurse representing the agency to visit the
1064 facility at least twice a year, rather than quarterly,
1065 to monitor residents who are receiving extended
1066 congregate care services; authorizing the agency to
1067 waive one of the required yearly monitoring visits
1068 under certain circumstances; authorizing the agency to
1069 deny or revoke a facility’s extended congregate care
1070 license; requiring a registered nurse representing the
1071 agency to visit the facility at least annually, rather
1072 than twice a year, to monitor residents who are
1073 receiving limited nursing services; providing that
1074 such monitoring visits may be conducted in conjunction
1075 with other inspections by the agency; authorizing the
1076 agency to waive the required yearly monitoring visit
1077 for a facility that is licensed to provide limited
1078 nursing services under certain circumstances; amending
1079 s. 429.075, F.S.; requiring an assisted living
1080 facility that serves one or more mental health
1081 residents to obtain a limited mental health license;
1082 revising the methods employed by a limited mental
1083 health facility relating to placement requirements to
1084 include providing written evidence that a request for
1085 a community living support plan, a cooperative
1086 agreement, and assessment documentation was sent to
1087 the Department of Children and Families within 72
1088 hours after admission; amending s. 429.14, F.S.;
1089 revising the circumstances under which the agency may
1090 deny, revoke, or suspend the license of an assisted
1091 living facility and impose an administrative fine;
1092 requiring the agency to deny or revoke the license of
1093 an assisted living facility under certain
1094 circumstances; requiring the agency to impose an
1095 immediate moratorium on the license of an assisted
1096 living facility under certain circumstances; deleting
1097 a provision requiring the agency to provide a list of
1098 facilities with denied, suspended, or revoked licenses
1099 to the Department of Business and Professional
1100 Regulation; exempting a facility from the 45-day
1101 notice requirement if it is required to relocate some
1102 or all of its residents; amending s. 429.178, F.S.;
1103 conforming cross-references; amending s. 429.19, F.S.;
1104 revising the amounts and uses of administrative fines;
1105 requiring the agency to levy a fine for violations
1106 that are corrected before an inspection if
1107 noncompliance occurred within a specified period of
1108 time; deleting factors that the agency is required to
1109 consider in determining penalties and fines; amending
1110 s. 429.256, F.S.; revising the term “assistance with
1111 self-administration of medication” as it relates to
1112 the Assisted Living Facilities Act; amending s.
1113 429.28, F.S.; providing notice requirements to inform
1114 facility residents that the identity of the resident
1115 and complainant in any complaint made to the State
1116 Long-Term Care Ombudsman Program or a local long-term
1117 care ombudsman council is confidential and that
1118 retaliatory action may not be taken against a resident
1119 for presenting grievances or for exercising any other
1120 resident right; requiring that a facility that
1121 terminates an individual’s residency after the filing
1122 of a complaint be fined if good cause is not shown for
1123 the termination; amending s. 429.34, F.S.; requiring
1124 certain persons to report elder abuse in assisted
1125 living facilities; requiring the agency to regularly
1126 inspect every licensed assisted living facility;
1127 requiring the agency to conduct more frequent
1128 inspections under certain circumstances; requiring the
1129 licensee to pay a fee for the cost of additional
1130 inspections; requiring the agency to annually adjust
1131 the fee; amending s. 429.41, F.S.; providing that
1132 certain staffing requirements apply only to residents
1133 in continuing care facilities who are receiving
1134 relevant services; amending s. 429.52, F.S.; requiring
1135 each newly hired employee of an assisted living
1136 facility to attend a preservice orientation provided
1137 by the assisted living facility; requiring the
1138 employee and administrator to sign a statement that
1139 the employee completed the required preservice
1140 orientation and keep the signed statement in the
1141 employee’s personnel record; requiring 2 additional
1142 hours of training for assistance with medication;
1143 conforming a cross-reference; requiring the Office of
1144 Program Policy Analysis and Government Accountability
1145 to study the reliability of facility surveys and
1146 submit to the Governor and the Legislature its
1147 findings and recommendations; creating s. 429.55,
1148 F.S.; requiring the Agency for Health Care
1149 Administration to implement a rating system of
1150 assisted living facilities by a specified date;
1151 authorizing the agency to adopt rules; requiring the
1152 Agency for Health Care Administration to provide
1153 specified data on assisted living facilities by a
1154 certain date; providing minimum requirements for such
1155 data; authorizing the agency to create a comment
1156 webpage regarding assisted living facilities;
1157 providing minimum requirements; authorizing the agency
1158 to provide links to certain third-party websites;
1159 providing appropriations; providing an effective date.