Florida Senate - 2019                                    SB 1088
       
       
        
       By Senator Albritton
       
       
       
       
       
       26-01180-19                                           20191088__
    1                        A bill to be entitled                      
    2         An act relating to nursing home facility staffing;
    3         amending s. 400.23, F.S.; revising direct care
    4         staffing requirements for nursing home facilities;
    5         requiring the Agency for Health Care Administration to
    6         include such requirements in rule; defining the term
    7         “direct care staff”; providing an effective date.
    8          
    9  Be It Enacted by the Legislature of the State of Florida:
   10  
   11         Section 1. Subsection (3) of section 400.23, Florida
   12  Statutes, is amended to read:
   13         400.23 Rules; evaluation and deficiencies; licensure
   14  status.—
   15         (3)(a)1. The agency shall adopt rules providing minimum
   16  staffing requirements for nursing home facilities. These
   17  requirements must include, for each facility:
   18         a. A minimum weekly average of certified nursing assistant
   19  and licensed nursing staffing combined of 3.9 3.6 hours of
   20  direct care staffing per resident per day as determined by
   21  facility assessment staffing needs in accordance with Federal
   22  Requirements of Participation. As used in this sub-subparagraph,
   23  a week is defined as Sunday through Saturday, and the term
   24  “direct care staff” includes those individuals who, through
   25  interpersonal contact with residents or resident care
   26  management, provide care and services that allow residents to
   27  attain or maintain their highest practicable physical, mental,
   28  and psychosocial states of well-being. The term does not include
   29  individuals whose primary duty is maintaining the physical
   30  environment of the facility. Direct care staffing hours do not
   31  include time spent on the following functions: nursing
   32  administration, staff development, staffing coordination, and
   33  the administrative portion of the minimum data set and care plan
   34  coordination.
   35         b. A minimum nonnursing direct care certified nursing
   36  assistant staffing of 2.5 hours of direct care per resident per
   37  day. A facility may not staff below one certified nursing
   38  assistant per 20 residents at any time.
   39         c. A minimum licensed nursing staffing of 1.0 hour of
   40  direct care per resident per day. A facility may not staff below
   41  one licensed nurse per 40 residents at any time.
   42         2. Nursing assistants employed under s. 400.211(2) may be
   43  included in computing the staffing ratio for certified nursing
   44  assistants if their job responsibilities include only nursing
   45  assistant-related duties.
   46         2.3. Each nursing home facility must document compliance
   47  with staffing standards as required under this paragraph and
   48  post daily the names of staff on duty for the benefit of
   49  facility residents and the public.
   50         3.4. The agency shall recognize the use of licensed nurses
   51  for compliance with minimum staffing requirements for direct
   52  care staff certified nursing assistants if the nursing home
   53  facility otherwise meets the minimum staffing requirements for
   54  licensed nurses and the licensed nurses are performing the
   55  duties of direct care staff a certified nursing assistant.
   56  Unless otherwise approved by the agency, licensed nurses counted
   57  toward the minimum staffing requirements for direct care staff
   58  certified nursing assistants must exclusively perform the duties
   59  of direct care staff a certified nursing assistant for the
   60  entire shift and not also be counted toward the minimum staffing
   61  requirements for licensed nurses. If the agency approved a
   62  facility’s request to use a licensed nurse to perform both
   63  licensed nursing and direct care staff certified nursing
   64  assistant duties, the facility must allocate the amount of staff
   65  time specifically spent on direct care staff certified nursing
   66  assistant duties for the purpose of documenting compliance with
   67  minimum staffing requirements for certified and licensed nursing
   68  staff. The hours of a licensed nurse with dual job
   69  responsibilities may not be counted twice.
   70         (b) Nonnursing staff providing eating assistance to
   71  residents shall not count toward compliance with minimum
   72  staffing standards.
   73         (b)(c) Licensed practical nurses licensed under chapter 464
   74  who are providing nursing services in nursing home facilities
   75  under this part may supervise the activities of other licensed
   76  practical nurses, certified nursing assistants, and other
   77  unlicensed personnel providing services in such facilities in
   78  accordance with rules adopted by the Board of Nursing.
   79         Section 2. This act shall take effect July 1, 2019.