Florida Senate - 2026                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1404
       
       
       
       
       
       
                                Ì589480=Î589480                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RS            .                                
                  02/24/2026           .                                
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       The Committee on Fiscal Policy (Burton) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 81 - 341
    4  and insert:
    5  by the assisted living facility as supportive services, as
    6  defined in subsection (29), that are optional and available to
    7  all residents of the facility.
    8         Section 2. Subsection (3) of section 429.07, Florida
    9  Statutes, is amended to read:
   10         429.07 License required; fee.—
   11         (3) In addition to the requirements of s. 408.806, each
   12  license granted by the agency must state the type of care for
   13  which the license is granted. Licenses shall be issued for one
   14  or more of the following categories of care: standard, extended
   15  congregate care, limited nursing services, or limited mental
   16  health, or memory care services.
   17         (a) A standard license shall be issued to facilities
   18  providing one or more of the personal services identified in s.
   19  429.02. Such facilities may also employ or contract with a
   20  person licensed under part I of chapter 464 to administer
   21  medications and perform other tasks as specified in s. 429.255.
   22         (b) An extended congregate care license shall be issued to
   23  each facility that has been licensed as an assisted living
   24  facility for 2 or more years and that provides services,
   25  directly or through contract, beyond those authorized in
   26  paragraph (a), including services performed by persons licensed
   27  under part I of chapter 464 and supportive services, as defined
   28  by rule, to persons who would otherwise be disqualified from
   29  continued residence in a facility licensed under this part. An
   30  extended congregate care license may be issued to a facility
   31  that has a provisional extended congregate care license and
   32  meets the requirements for licensure under subparagraph 2. The
   33  primary purpose of extended congregate care services is to allow
   34  residents the option of remaining in a familiar setting from
   35  which they would otherwise be disqualified for continued
   36  residency as they become more impaired. A facility licensed to
   37  provide extended congregate care services may also admit an
   38  individual who exceeds the admission criteria for a facility
   39  with a standard license, if he or she is determined appropriate
   40  for admission to the extended congregate care facility.
   41         1. In order for extended congregate care services to be
   42  provided, the agency must first determine that all requirements
   43  established in law and rule are met and must specifically
   44  designate, on the facility’s license, that such services may be
   45  provided and whether the designation applies to all or part of
   46  the facility. This designation may be made at the time of
   47  initial licensure or relicensure, or upon request in writing by
   48  a licensee under this part and part II of chapter 408. The
   49  notification of approval or the denial of the request shall be
   50  made in accordance with part II of chapter 408. Each existing
   51  facility that qualifies to provide extended congregate care
   52  services must have maintained a standard license and may not
   53  have been subject to administrative sanctions during the
   54  previous 2 years, or since initial licensure if the facility has
   55  been licensed for less than 2 years, for any of the following
   56  reasons:
   57         a. A class I or class II violation;
   58         b. Three or more repeat or recurring class III violations
   59  of identical or similar resident care standards from which a
   60  pattern of noncompliance is found by the agency;
   61         c. Three or more class III violations that were not
   62  corrected in accordance with the corrective action plan approved
   63  by the agency;
   64         d. Violation of resident care standards which results in
   65  requiring the facility to employ the services of a consultant
   66  pharmacist or consultant dietitian;
   67         e. Denial, suspension, or revocation of a license for
   68  another facility licensed under this part in which the applicant
   69  for an extended congregate care license has at least 25 percent
   70  ownership interest; or
   71         f. Imposition of a moratorium pursuant to this part or part
   72  II of chapter 408 or initiation of injunctive proceedings.
   73  
   74  The agency may deny or revoke a facility’s extended congregate
   75  care license for not meeting the criteria for an extended
   76  congregate care license as provided in this subparagraph.
   77         2. If an assisted living facility has been licensed for
   78  less than 2 years, the initial extended congregate care license
   79  must be provisional and may not exceed 6 months. The licensee
   80  shall notify the agency, in writing, when it has admitted at
   81  least one extended congregate care resident, after which an
   82  unannounced inspection shall be made to determine compliance
   83  with the requirements of an extended congregate care license. A
   84  licensee with a provisional extended congregate care license
   85  which demonstrates compliance with all the requirements of an
   86  extended congregate care license during the inspection shall be
   87  issued an extended congregate care license. In addition to
   88  sanctions authorized under this part, if violations are found
   89  during the inspection and the licensee fails to demonstrate
   90  compliance with all assisted living facility requirements during
   91  a follow-up followup inspection, the licensee shall immediately
   92  suspend extended congregate care services, and the provisional
   93  extended congregate care license expires. The agency may extend
   94  the provisional license for not more than 1 month in order to
   95  complete a follow-up followup visit.
   96         3. A facility that is licensed to provide extended
   97  congregate care services shall maintain a written progress
   98  report on each person who receives such nursing services from
   99  the facility’s staff which describes the type, amount, duration,
  100  scope, and outcome of services that are rendered and the general
  101  status of the resident’s health. A registered nurse, or
  102  appropriate designee, representing the agency shall visit the
  103  facility at least twice a year to monitor residents who are
  104  receiving extended congregate care services and to determine if
  105  the facility is in compliance with this part, part II of chapter
  106  408, and relevant rules. One of the visits may be in conjunction
  107  with the regular survey. The monitoring visits may be provided
  108  through contractual arrangements with appropriate community
  109  agencies. A registered nurse shall serve as part of the team
  110  that inspects the facility. The agency may waive one of the
  111  required yearly monitoring visits for a facility that has:
  112         a. Held an extended congregate care license for at least 24
  113  months;
  114         b. No class I or class II violations and no uncorrected
  115  class III violations; and
  116         c. No ombudsman council complaints that resulted in a
  117  citation for licensure.
  118         4. A facility that is licensed to provide extended
  119  congregate care services must:
  120         a. Demonstrate the capability to meet unanticipated
  121  resident service needs.
  122         b. Offer a physical environment that promotes a homelike
  123  setting, provides for resident privacy, promotes resident
  124  independence, and allows sufficient congregate space as defined
  125  by rule.
  126         c. Have sufficient staff available, taking into account the
  127  physical plant and firesafety features of the building, to
  128  assist with the evacuation of residents in an emergency.
  129         d. Adopt and follow policies and procedures that maximize
  130  resident independence, dignity, choice, and decisionmaking to
  131  permit residents to age in place, so that moves due to changes
  132  in functional status are minimized or avoided.
  133         e. Allow residents or, if applicable, a resident’s
  134  representative, designee, surrogate, guardian, or attorney in
  135  fact to make a variety of personal choices, participate in
  136  developing service plans, and share responsibility in
  137  decisionmaking.
  138         f. Implement the concept of managed risk.
  139         g. Provide, directly or through contract, the services of a
  140  person licensed under part I of chapter 464.
  141         h. In addition to the training mandated in s. 429.52,
  142  provide specialized training as defined by rule for facility
  143  staff.
  144         5. A facility that is licensed to provide extended
  145  congregate care services is exempt from the criteria for
  146  continued residency set forth in rules adopted under s. 429.41.
  147  A licensed facility must adopt its own requirements within
  148  guidelines for continued residency set forth by rule. However,
  149  the facility may not serve residents who require 24-hour nursing
  150  supervision. A licensed facility that provides extended
  151  congregate care services must also provide each resident with a
  152  written copy of facility policies governing admission and
  153  retention.
  154         6. Before the admission of an individual to a facility
  155  licensed to provide extended congregate care services, the
  156  individual must undergo a medical examination as provided in s.
  157  429.26(5) and the facility must develop a preliminary service
  158  plan for the individual.
  159         7. If a facility can no longer provide or arrange for
  160  services in accordance with the resident’s service plan and
  161  needs and the facility’s policy, the facility must make
  162  arrangements for relocating the person in accordance with s.
  163  429.28(1)(k).
  164         (c) A limited nursing services license shall be issued to a
  165  facility that provides services beyond those authorized in
  166  paragraph (a) and as specified in this paragraph.
  167         1. In order for limited nursing services to be provided in
  168  a facility licensed under this part, the agency must first
  169  determine that all requirements established in law and rule are
  170  met and must specifically designate, on the facility’s license,
  171  that such services may be provided. This designation may be made
  172  at the time of initial licensure or licensure renewal, or upon
  173  request in writing by a licensee under this part and part II of
  174  chapter 408. Notification of approval or denial of such request
  175  shall be made in accordance with part II of chapter 408. An
  176  existing facility that qualifies to provide limited nursing
  177  services must have maintained a standard license and may not
  178  have been subject to administrative sanctions that affect the
  179  health, safety, and welfare of residents for the previous 2
  180  years or since initial licensure if the facility has been
  181  licensed for less than 2 years.
  182         2. A facility that is licensed to provide limited nursing
  183  services shall maintain a written progress report on each person
  184  who receives such nursing services from the facility’s staff.
  185  The report must describe the type, amount, duration, scope, and
  186  outcome of services that are rendered and the general status of
  187  the resident’s health. A registered nurse representing the
  188  agency shall visit the facility at least annually to monitor
  189  residents who are receiving limited nursing services and to
  190  determine if the facility is in compliance with applicable
  191  provisions of this part, part II of chapter 408, and related
  192  rules. The monitoring visits may be provided through contractual
  193  arrangements with appropriate community agencies. A registered
  194  nurse shall also serve as part of the team that inspects such
  195  facility. Visits may be in conjunction with other agency
  196  inspections. The agency may waive the required yearly monitoring
  197  visit for a facility that has:
  198         a. Had a limited nursing services license for at least 24
  199  months;
  200         b. No class I or class II violations and no uncorrected
  201  class III violations; and
  202         c. No ombudsman council complaints that resulted in a
  203  citation for licensure.
  204         3. A person who receives limited nursing services under
  205  this part must meet the admission criteria established by the
  206  agency for assisted living facilities. When a resident no longer
  207  meets the admission criteria for a facility licensed under this
  208  part, arrangements for relocating the person shall be made in
  209  accordance with s. 429.28(1)(k), unless the facility is licensed
  210  to provide extended congregate care services.
  211         Section 3. Section 429.076, Florida Statutes, is created to
  212  read:
  213         429.076Memory care services license.—An assisted living
  214  facility that serves one or more memory care residents, or that
  215  advertises or otherwise holds itself out as providing memory
  216  care services, must obtain a memory care services license
  217  pursuant to subsection (3) or subsection (4), as applicable. A
  218  facility is not required to obtain a memory care services
  219  license if the facility solely provides supportive services, as
  220  defined in s. 429.02, for residents with Alzheimer’s disease and
  221  related dementias which are optional and available to all
  222  residents of the facility so long as the facility complies with
  223  agency rules on advertising pursuant to paragraph (2)(h).
  224         (1)To obtain a memory care services license, an assisted
  225  living facility must maintain a standard assisted living
  226  facility license and meet any additional minimum requirements
  227  adopted by rule. A memory care services license must be renewed
  228  at the same time as the facility’s standard license.
  229         (2)By June 1, 2027, the agency shall adopt rules to
  230  provide minimum standards for memory care services licenses.
  231  Such rules must include, but are not limited to:
  232         (a)Policies and procedures for providing memory care
  233  services.
  234         (b)Standardized admittance criteria for memory care
  235  residents.
  236         (c)The minimum level of care, services, and activities
  237  that must be provided to memory care residents.
  238         (d)Minimum training requirements for staff at a facility
  239  with a memory care services license, which must meet or exceed
  240  training requirements established in s. 430.5025.
  241         (e)Safety requirements specific to memory care residents,
  242  including, but not limited to, requiring a memory care services
  243  licensee to maintain at least one awake staff member to be on
  244  duty at all hours.
  245         (f)Physical plant requirements for a facility, or parts of
  246  a facility as specified by the licensee, serving memory care
  247  residents.
  248         (g)Requirements for contracts with memory care residents
  249  which, in addition to the requirements established by s. 429.24,
  250  must require a memory care services licensee to specify the
  251  memory care services that will be provided to the memory care
  252  resident.
  253         (h)Specified terms or terminologies that a facility may
  254  not use in its advertising without obtaining a memory care
  255  services license. Such terms include, but are not limited to,
  256  memory care, memory care facility, memory care services, memory
  257  care residents, dementia care, dementia care facility,
  258  Alzheimer’s care, and Alzheimer’s care facility. A facility that
  259  is not licensed to provide memory care services may advertise
  260  the supportive services, as defined in s. 429.02, it provides
  261  for persons with Alzheimer’s disease and related dementias so
  262  long as such advertisements do not use any terms or terminology
  263  prohibited by the agency’s rules pursuant to this subsection,
  264  such advertisements do not make any claim that the facility
  265  provides memory care services, and the facility maintains a copy
  266  of such advertisements in its records. The agency shall examine
  267  all such advertisements in the facility’s records as part of its
  268  licensure renewal procedure.
  269         (3)An assisted living facility licensed on or after the
  270  effective date of the rules required by subsection (2) must
  271  obtain a memory care services license to provide memory care
  272  services, serve memory care residents, or advertise or hold
  273  itself out as providing memory care services or otherwise
  274  serving memory care residents.
  275         (4)Except as provided in subsection (5), an assisted
  276  living facility licensed before the effective date of the rules
  277  required by subsection (2) must obtain a memory care services
  278  license within 6 months after the effective date of such rules
  279  in order to begin
  280  
  281  ================= T I T L E  A M E N D M E N T ================
  282  And the title is amended as follows:
  283         Delete lines 13 - 22
  284  and insert:
  285         services license; requiring that a memory care license
  286         be renewed at the same time as the assisted living
  287         facility’s standard license; requiring the Agency for
  288         Health Care Administration to adopt rules governing
  289         memory care services licenses by a specified date;
  290         specifying requirements for such rules; requiring an
  291         assisted living facility licensed on or after the
  292         effective date of such rules to obtain a memory care
  293         services license to carry out certain functions;
  294         requiring an assisted living facility licensed before
  295         the effective date of such rules to obtain a memory
  296         care services license within a specified timeframe
  297         after the effective date of such rules;