Florida Senate - 2012              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. SB 2074
       
       
       
       
       
                                Barcode 368338                          
       
       588-02542B-12                                                   
       Proposed Committee Substitute by the Committee on Health
       Regulation
    1                        A bill to be entitled                      
    2         An act relating to assisted living facilities;
    3         amending s. 394.4574, F.S.; revising the duties of the
    4         case manager for, and the community living support
    5         plan of, a mental health resident of an assisted
    6         living facility; amending s. 400.0078, F.S.; requiring
    7         residents of long-term care facilities to be informed
    8         about the confidentiality of the subject matter and
    9         identity of the complainant of a complaint received by
   10         the State Long-Term Care Ombudsman Program; amending
   11         s. 415.1034, F.S.; adding certain employees or agents
   12         of a state or local agency to the list of persons who
   13         must report the known or suspected abuse of a
   14         vulnerable adult to the abuse hotline; amending s.
   15         429.02, F.S.; providing definitions for “board” and
   16         “mental health professional”; amending s. 429.07,
   17         F.S.; conforming a cross-reference; increasing the
   18         biennial license fee required for a facility that has
   19         certain violations within the 2 years preceding
   20         license renewal; amending s. 429.075, F.S.; revising
   21         the criteria preventing a licensed facility from
   22         receiving a limited mental health license; providing
   23         training requirements for administrators and staff
   24         members of facilities that hold a limited mental
   25         health license; requiring that a mental health
   26         professional be part of the team inspecting a facility
   27         that holds a limited mental health license; requiring
   28         quarterly monitoring of the facility; providing for an
   29         exception from quarterly monitoring; amending s.
   30         429.14, F.S.; requiring the revocation of a facility
   31         license for certain violations that result in the
   32         death of a resident; amending s. 429.176, F.S.;
   33         requiring the licensure of facility administrators;
   34         providing administrator education and examination
   35         requirements; providing training requirements for
   36         facility managers during the temporary absence of an
   37         administrator; amending s. 429.178, F.S.; revising
   38         training requirements for staff who provide care for
   39         persons with Alzheimer’s disease and related
   40         disorders; amending s. 429.19, F.S.; conforming
   41         provisions to changes made by the act; authorizing the
   42         Agency for Health Care Administration to impose an
   43         increased fine for certain violations that result in
   44         the death of a resident; amending s. 429.23, F.S.;
   45         requiring a facility to establish a risk management
   46         and quality assurance program; amending s. 429.256,
   47         F.S.; conforming a cross-reference; amending s.
   48         429.28, F.S.; requiring residents of facilities to be
   49         informed about the confidentiality of the subject
   50         matter and identity of the resident and complainant of
   51         a complaint made to the State Long-Term Care Ombudsman
   52         Program; requiring the agency to conduct followup
   53         inspections of facilities that have a history of
   54         certain violations; providing that a facility that
   55         terminates an individual’s residency will be fined if
   56         good cause is not shown in court; amending s. 429.34,
   57         F.S.; providing that the agency is designated as the
   58         central agency for receiving and tracking facility
   59         complaints; requiring the agency to have lead
   60         surveyors who specialize in assessing facilities;
   61         amending s. 429.41, F.S.; requiring the agency to
   62         observe the elopement drills of a randomly selected
   63         group of facilities; authorizing the agency to require
   64         additional staffing for facilities that hold a
   65         specialty license; requiring the agency to conduct an
   66         abbreviated biennial licensure inspection; amending s.
   67         429.49, F.S.; increasing the criminal penalty for
   68         altering facility records; creating s. 429.515, F.S.;
   69         requiring new facility employees to attend a
   70         preservice orientation; providing requirements for
   71         such orientation; amending s. 429.52, F.S.; revising
   72         training and continuing education requirements for
   73         facility staff other than administrators; providing
   74         for the use of interactive online tutorials; creating
   75         s. 429.521, F.S.; providing specialty training
   76         requirements for certain staff of facilities that hold
   77         an extended congregate care, limited nursing, and
   78         limited mental health license; providing for
   79         examinations; authorizing the Board of Assisted Living
   80         Facility Administration to adopt rules; creating s.
   81         429.522, F.S.; requiring training providers to be
   82         certified by the board and provide trainer oversight;
   83         providing trainer requirements; requiring the board to
   84         maintain an electronic database of certified providers
   85         and persons who complete training if funding is
   86         available; creating s. 429.523, F.S.; providing for
   87         board approval of training and testing centers;
   88         providing approval criteria; amending s. 429.54, F.S.;
   89         requiring specified state agencies to have an
   90         electronic system of communication pertaining to the
   91         regulation of facilities; requiring facilities to
   92         submit certain facility and resident information
   93         electronically to the agency twice yearly; providing
   94         for the maintenance and use of such information;
   95         providing for expiration of this requirement; creating
   96         s. 429.55, F.S.; directing the agency to establish an
   97         online, user-friendly facility rating system that may
   98         be accessed by the public; providing a directive to
   99         the Division of Statutory Revision; amending s.
  100         498.1635, F.S.; revising the purpose of part II of ch.
  101         669, F.S., to include assisted living administrators;
  102         amending s. 468.1645, F.S.; requiring assisted living
  103         facilities to be operated under the management of a
  104         licensed administrator; amending s. 468.1655, F.S.;
  105         revising definitions to conform to changes made by the
  106         act; amending s. 468.1665, F.S.; revising the
  107         membership of the Board of Nursing Home and Assisted
  108         Living Facility Administrators; amending s. 468.1685,
  109         F.S.; revising the duties of the board to include the
  110         development of assisted living facility administrator
  111         training and examination, administrator continuing
  112         education curriculum, a limited mental health
  113         curriculum and examination, a staff training
  114         curriculum, an interactive online tutorial for
  115         facility staff, a continuing education curriculum for
  116         facility staff, and other training requirements as
  117         necessary; requiring the board to certify assisted
  118         living training providers and approve testing and
  119         training centers; amending s. 468.1695, F.S.;
  120         providing requirements for assisted living facility
  121         administrator examination; amending s. 468.1705, F.S.,
  122         relating to licensure by endorsement to conform to
  123         changes made by the act; amending s. 468.1725, F.S.;
  124         revising provisions relating to the inactive status of
  125         an administrator’s license; amending s. 468.1735,
  126         F.S., relating to provisional licensing; conforming
  127         provisions to changes made by the act; amending s.
  128         468.1745, F.S.; providing requirements for who must be
  129         licensed as an assisted living facility administrator;
  130         amending s. 468.1755, F.S.; conforming provisions to
  131         changes made by the act; providing grounds for
  132         disciplinary action for assisted living facility
  133         administrators; amending s. 468.1756, F.S.; conforming
  134         provisions to changes made by the act; requiring the
  135         agency to create a task force to determine whether
  136         state agencies have overlapping regulatory
  137         jurisdiction over facilities and to submit findings
  138         and recommendations to the Governor and Legislature by
  139         a certain date; providing for termination; requiring
  140         the Office of the State Long-Term Care Ombudsman to
  141         create a task force to review the agency’s facility
  142         inspection forms and to submit its recommendations to
  143         the agency by a certain date; providing for
  144         termination; providing an effective date.
  145  
  146  Be It Enacted by the Legislature of the State of Florida:
  147  
  148         Section 1. Paragraph (e) of subsection (2) of section
  149  394.4574, Florida Statutes, is amended, and paragraph (f) is
  150  added to that subsection, to read:
  151         394.4574 Department responsibilities for a mental health
  152  resident who resides in an assisted living facility that holds a
  153  limited mental health license.—
  154         (2) The department must ensure that:
  155         (e) The mental health services provider assigns a case
  156  manager to each mental health resident who lives in an assisted
  157  living facility with a limited mental health license. The case
  158  manager is responsible for coordinating the development of and
  159  implementation of the community living support plan defined in
  160  s. 429.02. The plan must be updated as needed, but at least
  161  annually, to ensure that the ongoing needs of the resident are
  162  addressed. Each case manager shall keep a record of the date and
  163  time of any face-to-face interaction with the mental health
  164  resident and make the record available to the department for
  165  inspection. The record must be retained for 2 years after the
  166  date of the last interaction.
  167         (f) There is adequate and consistent monitoring and
  168  enforcement of community living support plans and cooperative
  169  agreements by the department.
  170         Section 2. Subsection (2) of section 400.0078, Florida
  171  Statutes, is amended to read:
  172         400.0078 Citizen access to State Long-Term Care Ombudsman
  173  Program services.—
  174         (2) Every resident or representative of a resident shall
  175  receive, Upon admission to a long-term care facility, each
  176  resident or representative of a resident must receive
  177  information regarding the purpose of the State Long-Term Care
  178  Ombudsman Program, the statewide toll-free telephone number for
  179  receiving complaints, the confidentiality of the subject matter
  180  of a complaint and the complainant’s name and identity, and
  181  other relevant information regarding how to contact the program.
  182  Residents or their representatives must be furnished additional
  183  copies of this information upon request.
  184         Section 3. Paragraph (a) of subsection (1) of section
  185  415.1034, Florida Statutes, is amended to read:
  186         415.1034 Mandatory reporting of abuse, neglect, or
  187  exploitation of vulnerable adults; mandatory reports of death.—
  188         (1) MANDATORY REPORTING.—
  189         (a) Any person, including, but not limited to, any:
  190         1. A physician, osteopathic physician, medical examiner,
  191  chiropractic physician, nurse, paramedic, emergency medical
  192  technician, or hospital personnel engaged in the admission,
  193  examination, care, or treatment of vulnerable adults;
  194         2. A health professional or mental health professional
  195  other than one listed in subparagraph 1.;
  196         3. A practitioner who relies solely on spiritual means for
  197  healing;
  198         4. Nursing home staff; assisted living facility staff;
  199  adult day care center staff; adult family-care home staff;
  200  social worker; or other professional adult care, residential, or
  201  institutional staff;
  202         5. A state, county, or municipal criminal justice employee
  203  or law enforcement officer;
  204         6. An employee of the Department of Business and
  205  Professional Regulation conducting inspections of public lodging
  206  establishments under s. 509.032;
  207         7. A Florida advocacy council member or long-term care
  208  ombudsman council member; or
  209         8. A bank, savings and loan, or credit union officer,
  210  trustee, or employee; or
  211         9. An employee or agent of a state or local agency who has
  212  regulatory responsibilities over, or who provides services to,
  213  persons residing in a state-licensed facility,
  214  
  215  who knows, or has reasonable cause to suspect, that a vulnerable
  216  adult has been or is being abused, neglected, or exploited must
  217  shall immediately report such knowledge or suspicion to the
  218  central abuse hotline.
  219         Section 4. Subsections (5) and (11) of section 429.02,
  220  Florida Statutes, are amended, present subsections (6) through
  221  (14) of that section are redesignated as subsections (7) through
  222  (15), respectively, present subsections (15) through (26) of
  223  that section are redesignated as subsections (17) through (28),
  224  respectively, and new subsections (6) and (16) are added to that
  225  section, to read:
  226         429.02 Definitions.—When used in this part, the term:
  227         (5) “Assisted living facility” or “facility” means any
  228  building or buildings, section or distinct part of a building,
  229  private home, boarding home, home for the aged, or other
  230  residential facility, whether operated for profit or not, which
  231  undertakes through its ownership or management to provide
  232  housing, meals, and one or more personal services for a period
  233  exceeding 24 hours to one or more adults who are not relatives
  234  of the owner or administrator.
  235         (6) “Board” means the Board of Nursing Home and Assisted
  236  Living Facility Administrators established under s. 468.1665.
  237         (12)(11) “Extended congregate care” means acts beyond those
  238  authorized in subsection (18) which (16) that may be performed
  239  pursuant to part I of chapter 464 by persons licensed thereunder
  240  while carrying out their professional duties, and other
  241  supportive services which may be specified by rule. The purpose
  242  of such services is to enable residents to age in place in a
  243  residential environment despite mental or physical limitations
  244  that might otherwise disqualify them from residency in a
  245  facility licensed under this part.
  246         (16) “Mental health professional” means an individual
  247  licensed under chapter 458, chapter 459, chapter 464, chapter
  248  490, or chapter 491 who provides mental health services as
  249  defined in s. 394.67, or an individual who has a 4-year
  250  baccalaureate degree with a concentration in mental health from
  251  an accredited college or university and at least 5 years of
  252  experience providing services that improve an individual’s
  253  mental health or that treat mental illness.
  254         Section 5. Section 429.07, Florida Statutes, is amended to
  255  read:
  256         429.07 Facility license required; fee.—
  257         (1) The requirements of part II of chapter 408 apply to the
  258  provision of services that require licensure pursuant to this
  259  part and part II of chapter 408 and to entities licensed by or
  260  applying for such licensure from the agency pursuant to this
  261  part. A license issued by the agency is required in order to
  262  operate an assisted living facility in this state.
  263         (2) Separate licenses are shall be required for facilities
  264  maintained in separate premises, even though operated under the
  265  same management. A separate license is shall not be required for
  266  separate buildings on the same grounds.
  267         (3) In addition to the requirements of s. 408.806, each
  268  license granted by the agency must state the type of care for
  269  which the license is granted. Licenses shall be issued for one
  270  or more of the following categories of care: standard, extended
  271  congregate care, limited nursing services, or limited mental
  272  health.
  273         (a) A standard license shall be issued to facilities
  274  providing one or more of the personal services identified in s.
  275  429.02. Such facilities may also employ or contract with a
  276  person licensed under part I of chapter 464 to administer
  277  medications and perform other tasks as specified in s. 429.255.
  278         (b) An extended congregate care license shall be issued to
  279  facilities providing, directly or through contract, services
  280  beyond those authorized in paragraph (a), including services
  281  performed by persons licensed under part I of chapter 464 and
  282  supportive services, as defined by rule, to persons who would
  283  otherwise be disqualified from continued residence in a facility
  284  licensed under this part.
  285         1. In order for extended congregate care services to be
  286  provided, the agency must first determine that all requirements
  287  established in law and rule are met and must specifically
  288  designate, on the facility’s license, that such services may be
  289  provided and whether the designation applies to all or part of
  290  the facility. Such designation may be made at the time of
  291  initial licensure or relicensure, or upon request in writing by
  292  a licensee under this part and part II of chapter 408. The
  293  notification of approval or the denial of the request shall be
  294  made in accordance with part II of chapter 408. Existing
  295  facilities qualifying to provide extended congregate care
  296  services must have maintained a standard license and may not
  297  have been subject to administrative sanctions during the
  298  previous 2 years, or since initial licensure if the facility has
  299  been licensed for less than 2 years, for any of the following
  300  reasons:
  301         a. A class I or class II violation;
  302         b. Three or more repeat or recurring class III violations
  303  of identical or similar resident care standards from which a
  304  pattern of noncompliance is found by the agency;
  305         c. Three or more class III violations that were not
  306  corrected in accordance with the corrective action plan approved
  307  by the agency;
  308         d. Violation of resident care standards which results in
  309  requiring the facility to employ the services of a consultant
  310  pharmacist or consultant dietitian;
  311         e. Denial, suspension, or revocation of a license for
  312  another facility licensed under this part in which the applicant
  313  for an extended congregate care license had has at least 25
  314  percent ownership interest; or
  315         f. Imposition of a moratorium pursuant to this part or part
  316  II of chapter 408 or initiation of injunctive proceedings.
  317         2. A facility that is licensed to provide extended
  318  congregate care services must shall maintain a written progress
  319  report on each person who receives services which describes the
  320  type, amount, duration, scope, and outcome of services that are
  321  rendered and the general status of the resident’s health. A
  322  registered nurse, or appropriate designee, representing the
  323  agency shall visit the facility at least quarterly to monitor
  324  residents who are receiving extended congregate care services
  325  and to determine if the facility is in compliance with this
  326  part, part II of chapter 408, and relevant rules. One of the
  327  visits may be in conjunction with the regular survey. The
  328  monitoring visits may be provided through contractual
  329  arrangements with appropriate community agencies. A registered
  330  nurse shall serve as part of the team that inspects the
  331  facility. The agency may waive one of the required yearly
  332  monitoring visits for a facility that has been licensed for at
  333  least 24 months to provide extended congregate care services,
  334  if, during the inspection, the registered nurse determines that
  335  extended congregate care services are being provided
  336  appropriately, and if the facility has no class I or class II
  337  violations and no uncorrected class III violations. The agency
  338  must first consult with the long-term care ombudsman council for
  339  the area in which the facility is located to determine if any
  340  complaints have been made and substantiated about the quality of
  341  services or care. The agency may not waive one of the required
  342  yearly monitoring visits if complaints have been made and
  343  substantiated.
  344         3. A facility that is licensed to provide extended
  345  congregate care services must:
  346         a. Demonstrate the capability to meet unanticipated
  347  resident service needs.
  348         b. Offer a physical environment that promotes a homelike
  349  setting, provides for resident privacy, promotes resident
  350  independence, and allows sufficient congregate space as defined
  351  by rule.
  352         c. Have sufficient staff available, taking into account the
  353  physical plant and firesafety features of the building, to
  354  assist with the evacuation of residents in an emergency.
  355         d. Adopt and follow policies and procedures that maximize
  356  resident independence, dignity, choice, and decisionmaking in
  357  order to permit residents to age in place, so that moves due to
  358  changes in functional status are minimized or avoided.
  359         e. Allow residents or, if applicable, a resident’s
  360  representative, designee, surrogate, guardian, or attorney in
  361  fact to make a variety of personal choices, participate in
  362  developing service plans, and share responsibility in
  363  decisionmaking.
  364         f. Implement the concept of managed risk.
  365         g. Provide, directly or through contract, the services of a
  366  person licensed under part I of chapter 464.
  367         h. In addition to the training mandated in s. 429.52 and
  368  the specialized training provided in s. 429.521, provide
  369  specialized training as defined by rule for facility staff.
  370         4. A facility that is licensed to provide extended
  371  congregate care services is exempt from the criteria for
  372  continued residency set forth in rules adopted under s. 429.41.
  373  A licensed facility must adopt its own requirements within
  374  guidelines for continued residency set forth by rule. However,
  375  the facility may not serve residents who require 24-hour nursing
  376  supervision. A licensed facility that provides extended
  377  congregate care services must also provide each resident with a
  378  written copy of facility policies governing admission and
  379  retention.
  380         5. The primary purpose of extended congregate care services
  381  is to allow residents, as they become more impaired, the option
  382  of remaining in a familiar setting from which they would
  383  otherwise be disqualified for continued residency. A facility
  384  licensed to provide extended congregate care services may also
  385  admit an individual who exceeds the admission criteria for a
  386  facility with a standard license, if the individual is
  387  determined appropriate for admission to the extended congregate
  388  care facility.
  389         6. Before the admission of an individual to a facility
  390  licensed to provide extended congregate care services, the
  391  individual must undergo a medical examination as provided in s.
  392  429.26(4) and the facility must develop a preliminary service
  393  plan for the individual.
  394         7. If When a facility can no longer provide or arrange for
  395  services in accordance with the resident’s service plan and
  396  needs and the facility’s policy, the facility must shall make
  397  arrangements for relocating the person in accordance with s.
  398  429.28(1)(k).
  399         8. Failure to provide extended congregate care services may
  400  result in denial of extended congregate care license renewal.
  401         (c) A limited nursing services license shall be issued to a
  402  facility that provides services beyond those authorized in
  403  paragraph (a) and as specified in this paragraph.
  404         1. In order for limited nursing services to be provided in
  405  a facility licensed under this part, the agency must first
  406  determine that all requirements established in law and rule are
  407  met and must specifically designate, on the facility’s license,
  408  that such services may be provided. Such designation may be made
  409  at the time of initial licensure or relicensure, or upon request
  410  in writing by a licensee under this part and part II of chapter
  411  408. Notification of approval or denial of such request shall be
  412  made in accordance with part II of chapter 408. Existing
  413  facilities qualifying to provide limited nursing services shall
  414  have maintained a standard license and may not have been subject
  415  to administrative sanctions that affect the health, safety, and
  416  welfare of residents for the previous 2 years or since initial
  417  licensure if the facility has been licensed for less than 2
  418  years.
  419         2. Facilities that are licensed to provide limited nursing
  420  services shall maintain a written progress report on each person
  421  who receives such nursing services, which report describes the
  422  type, amount, duration, scope, and outcome of services that are
  423  rendered and the general status of the resident’s health. A
  424  registered nurse representing the agency shall visit such
  425  facilities at least twice a year to monitor residents who are
  426  receiving limited nursing services and to determine if the
  427  facility is in compliance with applicable provisions of this
  428  part, part II of chapter 408, and related rules. The monitoring
  429  visits may be provided through contractual arrangements with
  430  appropriate community agencies. A registered nurse shall also
  431  serve as part of the team that inspects such facility.
  432         3. A person who receives limited nursing services under
  433  this part must meet the admission criteria established by the
  434  agency for assisted living facilities. When a resident no longer
  435  meets the admission criteria for a facility licensed under this
  436  part, arrangements for relocating the person shall be made in
  437  accordance with s. 429.28(1)(k), unless the facility is licensed
  438  to provide extended congregate care services.
  439         (4) In accordance with s. 408.805, an applicant or licensee
  440  shall pay a fee for each license application submitted under
  441  this part, part II of chapter 408, and applicable rules. The
  442  amount of the fee shall be established by rule.
  443         (a) The biennial license fee required of a facility is $300
  444  per license, plus with an additional fee of $50 per resident
  445  based on the total licensed resident capacity of the facility,
  446  except that an no additional fee may not will be assessed for
  447  beds designated for recipients of optional state supplementation
  448  payments provided under for in s. 409.212. The total fee may not
  449  exceed $10,000. However, the biennial license fee for a licensed
  450  facility that has one or more class I or class II violations
  451  within the 2 years before licensure renewal is $500 per license
  452  plus a fee of $55 per resident. The increased fee amounts are in
  453  addition to any adjusted fee amounts imposed pursuant to s.
  454  408.805. The total fee for such facilities may not exceed
  455  $20,000. The increased fees shall be imposed for one licensure
  456  cycle, unless the facility has a class I or class II violation
  457  during the next biennial inspection.
  458         (b) In addition to the total fee assessed under paragraph
  459  (a), the agency shall require facilities that are licensed to
  460  provide extended congregate care services under this part to pay
  461  an additional fee per licensed facility. The amount of the
  462  biennial fee shall be $400 per license, with an additional fee
  463  of $10 per resident based on the total licensed resident
  464  capacity of the facility.
  465         (c) In addition to the total fee assessed under paragraph
  466  (a), the agency shall require facilities that are licensed to
  467  provide limited nursing services under this part to pay an
  468  additional fee per licensed facility. The amount of the biennial
  469  fee shall be $250 per license, with an additional fee of $10 per
  470  resident based on the total licensed resident capacity of the
  471  facility.
  472         (5) Counties or municipalities applying for licenses under
  473  this part are exempt from the payment of license fees.
  474         Section 6. Section 429.075, Florida Statutes, is amended to
  475  read:
  476         429.075 Limited mental health license.—An assisted living
  477  facility that serves three or more mental health residents must
  478  obtain a limited mental health license.
  479         (1) To obtain a limited mental health license, a facility
  480  must hold a standard license as an assisted living facility and,
  481  must not have been subject to administrative sanctions during
  482  the previous 2 years, or since initial licensure if the facility
  483  has been licensed for less than 2 years, for any of the
  484  following reasons:
  485         (a) Two or more class I or class II violations;
  486         (b) Three or more repeat or recurring class III violations
  487  of identical or similar resident care standards from which a
  488  pattern of noncompliance is found by the agency;
  489         (c) Three or more class III violations that were not
  490  corrected in accordance with the facility’s corrective action
  491  plan approved by the agency;
  492         (d) A violation of resident care standards which resulted
  493  in requiring the facility to employ the consultant services of a
  494  licensed pharmacist or a registered or licensed dietitian under
  495  s. 429.42;
  496         (e) Denial, suspension, or revocation of a license for
  497  another facility licensed under this part in which the license
  498  applicant had at least a 25 percent ownership interest; or
  499         (f) Imposition of a moratorium pursuant to this part or
  500  part II of chapter 408 or initiation of injunctive proceedings
  501  any current uncorrected deficiencies or violations, and must
  502  ensure that, within 6 months after receiving a limited mental
  503  health license, the facility administrator and the staff of the
  504  facility who are in direct contact with mental health residents
  505  must complete training of no less than 6 hours related to their
  506  duties. Such designation
  507         (2) Licensure to provide services to mental health
  508  residents may be made at the time of initial licensure or
  509  relicensure or upon request in writing by a licensee under this
  510  part and part II of chapter 408. Notification of agency approval
  511  or denial of such request must shall be made in accordance with
  512  this part, part II of chapter 408, and applicable rules. This
  513  training will be provided by or approved by the Department of
  514  Children and Family Services.
  515         (3)(2) Facilities licensed to provide services to mental
  516  health residents shall provide appropriate supervision and
  517  staffing to provide for the health, safety, and welfare of such
  518  residents.
  519         (a) In addition to the general training or educational
  520  requirements under this part or part II of chapter 468, as
  521  applicable, each administrator and staff member who provides
  522  regular or direct care to the residents of a facility licensed
  523  to provide services to mental health residents must meet the
  524  specialized limited mental health training requirements set
  525  forth in s. 429.521.
  526         (b) Effective July 1, 2012, an administrator of a facility
  527  that has a limited mental health license, in addition to the
  528  education requirements under part II of chapter 468, must have
  529  also completed at least 6 semester credit hours of college-level
  530  coursework relating to mental health.
  531         (4)(3) A facility that holds has a limited mental health
  532  license must:
  533         (a) Have a copy of each mental health resident’s community
  534  living support plan and the cooperative agreement with the
  535  mental health care services provider. The support plan and the
  536  agreement may be combined.
  537         (b) Have documentation that is provided by the Department
  538  of Children and Family Services that each mental health resident
  539  has been assessed and determined to be able to live in the
  540  community in an assisted living facility with a limited mental
  541  health license.
  542         (c) Make the community living support plan available for
  543  inspection by the resident, the resident’s legal guardian, the
  544  resident’s health care surrogate, and other individuals who have
  545  a lawful basis for reviewing this document.
  546         (d) Assist the mental health resident in carrying out the
  547  activities identified in the individual’s community living
  548  support plan.
  549         (5)(4) A facility that holds with a limited mental health
  550  license may enter into a cooperative agreement with a private
  551  mental health provider. For purposes of the limited mental
  552  health license, the private mental health provider may act as
  553  the case manager.
  554         (6)A mental health professional shall serve as part of the
  555  team that inspects a facility that holds a limited mental health
  556  license, and may conduct the inspection without other agency
  557  representatives. A mental health professional representing the
  558  agency shall visit the facility at least quarterly to monitor
  559  residents who are receiving limited mental health services and
  560  to determine if the facility is in compliance with this part,
  561  part II of chapter 408, and relevant rules, and may send a
  562  report to the agency reporting his or her findings. One of those
  563  visits may be in conjunction with the agency’s regular survey.
  564  The monitoring visits may be provided through a contractual
  565  arrangement with an appropriate community agency. The agency may
  566  waive one of the quarterly monitoring visits of a facility that
  567  has had a mental health license for at least 2 years if, during
  568  an inspection, the mental health professional determines that
  569  mental health services are being provided appropriately and the
  570  facility has had no class I or class II violation and no
  571  uncorrected class III violation in the past 2 years. Before
  572  waiving a monitoring visit, the agency must first consult with a
  573  representative of the local long-term care ombudsman council for
  574  the area in which the facility is located to determine if any
  575  complaint has been made and the outcome of the complaint. The
  576  agency may not waive one of the required monitoring visits if an
  577  ombudsman referral was made to the agency which resulted in a
  578  citation for a licensure violation.
  579         Section 7. Subsection (4) of section 429.14, Florida
  580  Statutes, is amended to read:
  581         429.14 Administrative penalties.—
  582         (4) The agency shall deny or revoke the license of an
  583  assisted living facility that:
  584         (a) Has two or more class I or class II violations that are
  585  similar or identical to violations identified by the agency
  586  during a survey, inspection, monitoring visit, or complaint
  587  investigation occurring within the previous 2 years; or.
  588         (b) Committed a class I violation that caused the death of
  589  a resident or an intentional or negligent act that, based on a
  590  court’s findings, caused the death of a resident.
  591         Section 8. Section 429.176, Florida Statutes, is amended to
  592  read:
  593         429.176 Notice of change of Administrator license;
  594  educational requirements; change of administrator; managers.—
  595         (1) To be an administrator of an assisted living facility,
  596  an applicant must meet the requirements under part I of chapter
  597  468. 
  598         (2) A licensed administrator must complete a minimum of 18
  599  hours of continuing education every 2 years and pass a short
  600  examination that corresponds to each continuing education course
  601  with a minimum score of 80 in order to demonstrate receipt and
  602  comprehension of the training. The examination may be offered
  603  online and any fees associated with the online service must be
  604  borne by the participant. The license of a facility whose
  605  administrator had not maintained these continuing education
  606  requirements shall enter inactive status.
  607         (3) The administrator of a facility that holds a limited
  608  mental health license must have met the educational requirements
  609  of s. 429.521(3).
  610         (4) If, during the period for which a standard license is
  611  issued, the facility owner changes administrators, the owner
  612  must notify the agency of the change within 10 days and provide
  613  documentation that the administrator is licensed or has been
  614  granted a provisional license within 90 days that the new
  615  administrator has completed the applicable core educational
  616  requirements under s. 429.52.
  617         (5) A manager of a facility who assumes responsibility for
  618  the operation of the facility during the temporary absence of an
  619  administrator must meet the core training requirements under s.
  620  468.1685(9)(a) within 30 days after being employed as, or
  621  becoming, a facility manager.
  622         Section 9. Paragraphs (a) and (b) of subsection (2) of
  623  section 429.178, Florida Statutes, are amended to read:
  624         429.178 Special care for persons with Alzheimer’s disease
  625  or other related disorders.—
  626         (2)(a) Staff members, including administrators, An
  627  individual who are is employed by a facility that provides
  628  special care for residents with Alzheimer’s disease or other
  629  related disorders, and who provide has regular or direct care to
  630  contact with such residents, must complete up to 4 hours of
  631  initial dementia-specific training developed or approved by the
  632  department. The training must shall be completed within 3 months
  633  after beginning employment and shall satisfy the core training
  634  requirements of s. 429.52(2)(g).
  635         (b) A direct caregiver who is employed by a facility that
  636  provides special care for residents with Alzheimer’s disease or
  637  other related disorders, and who provides direct care to such
  638  residents, must complete the required initial training and 4
  639  additional hours of training developed or approved by the
  640  department. The training must shall be completed within 6 months
  641  9 months after beginning employment and shall satisfy the core
  642  training requirements of s. 429.52(2)(g).
  643         Section 10. Subsections (1) and (2) of section 429.19,
  644  Florida Statutes, are amended to read:
  645         429.19 Violations; imposition of administrative fines;
  646  grounds.—
  647         (1) In addition to the requirements of part II of chapter
  648  408 and s. 429.28(6), the agency shall impose an administrative
  649  fine in the manner provided under in chapter 120 for the
  650  violation of any provision of this part, part II of chapter 408,
  651  and applicable rules by an assisted living facility;, for the
  652  actions of any person subject to level 2 background screening
  653  under s. 408.809;, for the actions of any facility employee;, or
  654  for an intentional or negligent act seriously affecting the
  655  health, safety, or welfare of a resident of the facility.
  656         (2) Each violation of this part and adopted rules shall be
  657  classified according to the nature of the violation and the
  658  gravity of its probable effect on facility residents as provided
  659  in s. 408.813.
  660         (a) The agency shall indicate the classification on the
  661  written notice of the violation as follows:
  662         1.(a)For class “I” violations, are defined in s. 408.813.
  663  the agency shall impose an administrative fine for a cited class
  664  I violation in an amount not less than $5,000 and not exceeding
  665  $10,000 for each violation.
  666         2.(b)For class “II” violations, are defined in s. 408.813.
  667  the agency shall impose an administrative fine for a cited class
  668  II violation in an amount not less than $1,000 and not exceeding
  669  $5,000 for each violation.
  670         3.(c)For class “III” violations, are defined in s.
  671  408.813. the agency shall impose an administrative fine for a
  672  cited class III violation in an amount not less than $500 and
  673  not exceeding $1,000 for each violation even if the violation is
  674  corrected before the citation is issued.
  675         4.(d)For class “IV” violations, are defined in s. 408.813.
  676  the agency shall impose an administrative fine for a cited class
  677  IV violation in an amount not less than $100 and not exceeding
  678  $200 for each violation.
  679         (b) The agency shall impose the maximum penalty for the
  680  class of violation which results in the death of a resident. If
  681  the facility is cited for a second or subsequent violation that
  682  is in the same class as a prior violation that the facility has
  683  been cited for at, or since, the last inspection, the agency
  684  shall double the fine for the second or subsequent violation
  685  even if the fine exceeds the maximum amount authorized.
  686  Notwithstanding s. 408.813(c), if a facility is cited for ten or
  687  more class III violations during an inspection or survey, the
  688  agency shall impose a fine for each violation.
  689         Section 11. Subsection (1) of section 429.23, Florida
  690  Statutes, is amended to read:
  691         429.23 Internal risk management and quality assurance
  692  program; adverse incidents and reporting requirements.—
  693         (1) As part of its administrative functions, an assisted
  694  living Every facility licensed under this part shall may, as
  695  part of its administrative functions, voluntarily establish a
  696  risk management and quality assurance program, the purpose of
  697  which is to assess resident care practices, facility incident
  698  reports, deficiencies cited by the agency, adverse incident
  699  reports, and resident grievances and develop plans of action to
  700  correct and respond quickly to identify quality differences.
  701         Section 12. Paragraph (b) of subsection (1) of section
  702  429.256, Florida Statutes, is amended to read:
  703         429.256 Assistance with self-administration of medication.—
  704         (1) For the purposes of this section, the term:
  705         (b) “Unlicensed person” means an individual not currently
  706  licensed to practice nursing or medicine who is employed by or
  707  under contract to an assisted living facility and who has
  708  received training with respect to assisting with the self
  709  administration of medication in an assisted living facility, as
  710  provided under s. 429.521, before 429.52 prior to providing such
  711  assistance as described in this section.
  712         Section 13. Subsection (2), paragraph (d) of subsection
  713  (3), and subsection (6) of section 429.28, Florida Statutes, are
  714  amended to read:
  715         429.28 Resident bill of rights.—
  716         (2) The administrator of a facility shall ensure that a
  717  written notice of the rights, obligations, and prohibitions set
  718  forth in this part is posted in a prominent place in each
  719  facility and read or explained to residents who cannot read. The
  720  This notice must shall include the name, address, and telephone
  721  numbers of the local ombudsman council and central abuse hotline
  722  and, if when applicable, the Advocacy Center for Persons with
  723  Disabilities, Inc., and the Florida local advocacy council,
  724  where complaints may be lodged. The notice must state that the
  725  subject matter of a complaint made to the Office of State Long
  726  Term Care Ombudsman or a local long-term care ombudsman council
  727  and the names and identities of the residents involved in the
  728  complaint and the complainants are confidential pursuant to s.
  729  400.0077. The facility must ensure a resident’s access to a
  730  telephone to call the local ombudsman council, central abuse
  731  hotline, Advocacy Center for Persons with Disabilities, Inc.,
  732  and the Florida local advocacy council.
  733         (3)
  734         (d) The agency shall conduct periodic followup inspections
  735  to monitor the compliance of facilities having a history of
  736  class I violations that threaten the health, safety, or security
  737  of residents, and may conduct periodic followup inspections as
  738  necessary to monitor the compliance of facilities having with a
  739  history of any class I, class II, or class III violations that
  740  threaten the health, safety, or security of residents.
  741         (6) A Any facility that which terminates the residency of
  742  an individual who participated in activities specified in
  743  subsection (5) must shall show good cause in a court of
  744  competent jurisdiction. If good cause is not shown, the agency
  745  shall impose a fine of $2,500 in addition to any other penalty
  746  assessed against the facility.
  747         Section 14. Section 429.34, Florida Statutes, is amended to
  748  read:
  749         429.34 Right of entry and inspection.—
  750         (1) In addition to the requirements of s. 408.811, a any
  751  duly designated officer or employee of the department, the
  752  Department of Children and Family Services, the Medicaid Fraud
  753  Control Unit of the Office of the Attorney General, the state or
  754  local fire marshal, or a member of the state or local long-term
  755  care ombudsman council shall have the right to enter unannounced
  756  upon and into the premises of any facility licensed pursuant to
  757  this part in order to determine the state of compliance with the
  758  provisions of this part, part II of chapter 408, and applicable
  759  rules. Data collected by the state or local long-term care
  760  ombudsman councils or the state or local advocacy councils may
  761  be used by the agency in investigations involving violations of
  762  regulatory standards.
  763         (2) The agency is designated the central agency for
  764  receiving and tracking complaints to ensure that allegations
  765  regarding facilities are timely responded to and that licensure
  766  enforcement action is initiated if warranted. Any other state
  767  agency regulating, or providing services to residents of,
  768  assisted living facilities must report any allegations or
  769  complaints that have been substantiated or are likely to have
  770  occurred to the agency as soon as reasonably possible.
  771         (3) The agency shall have lead surveyors in each field
  772  office who specialize in assessing assisted living facilities.
  773  The lead surveyors shall provide initial and ongoing training to
  774  surveyors who will be inspecting and monitoring facilities. The
  775  lead surveyors shall ensure that consistent inspection and
  776  monitoring assessments are conducted.
  777         (4) The agency shall have one statewide lead surveyor who
  778  specializes in assisted living facility inspections. The lead
  779  surveyor shall coordinate communication between lead surveyors
  780  of assisted living facilities throughout the state and ensure
  781  statewide consistency in applying facility inspection laws and
  782  rules.
  783         Section 15. Paragraph (l) of subsection (1) and subsections
  784  (2) and (5) of section 429.41, Florida Statutes, are amended to
  785  read:
  786         429.41 Rules establishing standards.—
  787         (1) It is the intent of the Legislature that rules
  788  published and enforced pursuant to this section shall include
  789  criteria by which a reasonable and consistent quality of
  790  resident care and quality of life may be ensured and the results
  791  of such resident care may be demonstrated. Such rules shall also
  792  ensure a safe and sanitary environment that is residential and
  793  noninstitutional in design or nature. It is further intended
  794  that reasonable efforts be made to accommodate the needs and
  795  preferences of residents to enhance the quality of life in a
  796  facility. The agency, in consultation with the department, may
  797  adopt rules to administer the requirements of part II of chapter
  798  408. In order to provide safe and sanitary facilities and the
  799  highest quality of resident care accommodating the needs and
  800  preferences of residents, the department, in consultation with
  801  the agency, the Department of Children and Family Services, and
  802  the Department of Health, shall adopt rules, policies, and
  803  procedures to administer this part, which must include
  804  reasonable and fair minimum standards in relation to:
  805         (l) The establishment of specific policies and procedures
  806  on resident elopement. Facilities shall conduct a minimum of two
  807  resident elopement drills each year. All administrators and
  808  direct care staff shall participate in the drills. Facilities
  809  shall document the drills. Each calendar year, the agency shall
  810  observe the elopement drills of 10 percent of the licensed
  811  facilities in the state. The facilities must be randomly
  812  selected by the agency and the elopement drills must coincide
  813  with an inspection or survey conducted by the agency. If an
  814  agency employee observes an elopement drill that does not meet
  815  standards established by rule, the agency shall provide notice
  816  of the deficiencies to the facility within 15 calendar days
  817  after the drill. The facility shall submit a corrective action
  818  plan to the agency within 30 calendar days after receiving such
  819  notice.
  820         (2) In adopting any rules pursuant to this part, the
  821  department, in conjunction with the agency, shall make distinct
  822  standards for facilities based upon facility size; the types of
  823  care provided; the physical and mental capabilities and needs of
  824  residents; the type, frequency, and amount of services and care
  825  offered; and the staffing characteristics of the facility. Rules
  826  developed pursuant to this section may shall not restrict the
  827  use of shared staffing and shared programming in facilities that
  828  are part of retirement communities that provide multiple levels
  829  of care and otherwise meet the requirements of law and rule. The
  830  department may require additional staffing for facilities that
  831  have specialty licenses, but the additional staffing must
  832  correlate with the number of residents receiving special care
  833  and the type of special care required. Except for uniform
  834  firesafety standards, the department shall adopt by rule
  835  separate and distinct standards for facilities with 16 or fewer
  836  beds and for facilities with 17 or more beds. The standards for
  837  facilities with 16 or fewer beds must shall be appropriate for a
  838  noninstitutional residential environment if, provided that the
  839  structure is no more than two stories in height and all persons
  840  who cannot exit the facility unassisted in an emergency reside
  841  on the first floor. The department, in conjunction with the
  842  agency, may make other distinctions among types of facilities as
  843  necessary to enforce the provisions of this part. If Where
  844  appropriate, the agency shall offer alternate solutions for
  845  complying with established standards, based on distinctions made
  846  by the department and the agency relative to the physical
  847  characteristics of facilities and the types of care offered
  848  therein.
  849         (5) In order to allocate resources efficiently, the agency
  850  shall conduct may use an abbreviated biennial standard licensure
  851  inspection that consists of a review of key quality-of-care
  852  standards in lieu of a full inspection in a facility that has a
  853  good record of past performance. However, a full inspection must
  854  be conducted in a facility that has a history of class I or
  855  class II violations, uncorrected class III violations, confirmed
  856  ombudsman council complaints, or confirmed licensure complaints,
  857  within the previous licensure period immediately preceding the
  858  inspection or if a potentially serious problem is identified
  859  during the abbreviated inspection. The agency, in consultation
  860  with the department, shall develop the key quality-of-care
  861  standards with input from the State Long-Term Care Ombudsman
  862  Council and representatives of provider groups for incorporation
  863  into its rules.
  864         Section 16. Subsection (1) of section 429.49, Florida
  865  Statutes, is amended to read:
  866         429.49 Resident records; penalties for alteration.—
  867         (1) Any person who fraudulently alters, defaces, or
  868  falsifies any medical or other record of an assisted living
  869  facility, or causes or procures any such offense to be
  870  committed, commits a misdemeanor of the first second degree,
  871  punishable as provided in s. 775.082 or s. 775.083.
  872         Section 17. Section 429.515, Florida Statutes, is created
  873  to read:
  874         429.515Preservice orientation.—
  875         (1) Effective July 1, 2012, a new employee, including an
  876  administrator, of an assisted living facility must attend a
  877  preservice orientation provided by the facility which covers
  878  topics that will enable the employee to relate and respond to
  879  the residents of that facility. The orientation must be at least
  880  2 hours in duration, be available in English and Spanish, and,
  881  at a minimum, cover the following topics:
  882         (a) Care of persons who have Alzheimer’s disease or other
  883  related disorders.
  884         (b) Deescalation techniques.
  885         (c) Aggression control.
  886         (d) Elopement prevention.
  887         (e) Behavior management.
  888         (2)Upon completion of the preservice orientation, the
  889  employee must sign an affidavit, under penalty of perjury,
  890  stating that the employee completed the orientation. The
  891  administrator of the facility must maintain the signed affidavit
  892  in the employee’s work file.
  893         Section 18. Section 429.52, Florida Statutes, is amended to
  894  read:
  895         (Substantial rewording of section. See
  896         s. 429.52, F.S., for present text.)
  897         429.52Staff member training; tutorial; continuing
  898  education.—
  899         (1) Staff members, other than administrators, providing
  900  regular or direct care to residents must complete a staff
  901  training curriculum developed by the board. The training must be
  902  completed within 30 days after employment and is in addition to
  903  the preservice orientation required under s. 429.515. Any cost
  904  or fee associated with the training shall be borne by the
  905  participant or the participant’s employer.
  906         (2) Staff members, other than administrators, providing
  907  regular or direct care to residents must complete an interactive
  908  online tutorial developed by the board that demonstrates an
  909  understanding of the training received under subsection (1). The
  910  board shall provide a certificate to each staff member who
  911  completes the tutorial. The certificate must be maintained in
  912  the employee’s work file.
  913         (3) Staff members, other than administrators, providing
  914  regular or direct care to residents must participate in a
  915  minimum of 8 hours of continuing education every 2 years as
  916  developed by the board. The continuing education may be offered
  917  through online courses and any fee associated with the online
  918  service shall be borne by the participant or the participant’s
  919  employer.
  920         Section 19. Section 429.521, Florida Statutes, is created
  921  to read:
  922         429.521Specialty training and education; examinations.—
  923         (1) Administrators and staff members who provide regular or
  924  direct care to residents of a facility that holds an extended
  925  congregate care license must complete a minimum of 6 hours of
  926  board-approved extended congregate care training within 30 days
  927  after beginning employment.
  928         (2) If a facility holds a limited nursing services license:
  929         (a) The administrator must complete a minimum of 4 hours of
  930  board-approved courses that train and educate administrators on
  931  the special needs and care of those requiring limited nursing
  932  services.
  933         (b) Staff members providing regular and direct care to
  934  residents receiving limited nursing services must complete a
  935  minimum of 2 hours of courses that train and educate staff on
  936  the special needs and care of those requiring limited nursing
  937  services. The training must be completed within 30 days after
  938  employment.
  939         (3) Staff members who provide regular or direct care to
  940  mental health residents and administrators who are employed by a
  941  facility that holds a limited mental health license must
  942  complete a minimum of 8 hours of board-approved mental health
  943  training within 30 days after beginning employment. Within 30
  944  days after completing such training, a staff member must
  945  complete an online interactive tutorial related to the training
  946  and receive a certificate of completion in order to demonstrate
  947  an understanding of the training received. An administrator must
  948  pass an examination related to the administrator’s training with
  949  a minimum score of 80. The participant or the participant’s
  950  employer shall pay any fee associated with taking the tutorial
  951  or examination.
  952         (a) A staff member who does not complete the tutorial or an
  953  administrator who fails the examination may not provide regular
  954  or direct care to mental health residents until he or she
  955  successfully completes the tutorial or passes the examination.
  956         (b) An administrator who does not pass the examination
  957  within 6 months after completing the mental health training may
  958  not be an administrator of a facility that holds a limited
  959  mental health license until the administrator achieves a passing
  960  score.
  961         (4) Staff, including administrators, who prepare or serve
  962  food must receive a minimum of 1 hour of inservice training in
  963  safe food handling practices within 30 days after beginning
  964  employment.
  965         (5) Staff members, including administrators, must receive
  966  at least 1 hour of inservice training on the facility’s resident
  967  elopement response policies and procedures within 30 days after
  968  beginning employment.
  969         (a) A copy of the facility’s resident elopement response
  970  policies and procedures must be provided to staff members and
  971  the administrator.
  972         (b) Staff members and the administrator must demonstrate
  973  understanding and competency in the implementation of the
  974  elopement response policies and procedures.
  975         (6) Staff members, including the administrator, involved
  976  with the management of medications and the assistance with self
  977  administration of medications under s. 429.256 must complete a
  978  minimum of 4 additional hours of training provided by a
  979  registered nurse, licensed pharmacist, or department staff
  980  member. The board shall establish by rule the minimum
  981  requirements of this training, including continuing education
  982  requirements.
  983         (7)Other facility staff members shall participate in
  984  training relevant to their job duties as specified by board
  985  rule.
  986         Section 20. Section 429.522, Florida Statutes, is created
  987  to read:
  988         429.522Assisted living training providers; certification.—
  989         (1) Effective January 1, 2013, an individual seeking to
  990  provide assisted living training in this state must be certified
  991  by the board. The applicant must provide the board with proof of
  992  completion of the minimum core training requirements, successful
  993  passage of the assisted living facility administrator licensure
  994  examination, and proof of compliance with any continuing
  995  education requirements.
  996         (2) A person seeking to be certified as a trainer must
  997  also:
  998         (a) Provide proof of completion of a 4-year baccalaureate
  999  degree from an accredited college or university and have worked
 1000  in a management position in an assisted living facility for 3
 1001  years after obtaining certification in core training courses;
 1002         (b) Have worked in a management position in an assisted
 1003  living facility for 5 years after obtaining certification in the
 1004  core training courses and have 1 year of teaching experience as
 1005  an educator or staff trainer for persons who work in an assisted
 1006  living facility or another long-term care setting;
 1007         (c) Have been previously employed as a trainer of core
 1008  training courses for the department;
 1009         (d) Have at least 5 years of employment with the agency as
 1010  a surveyor of assisted living facilities;
 1011         (e) Have at least 5 years of employment in a professional
 1012  position in the agency’s assisted living unit;
 1013         (f) Have at least 5 years of employment as an educator or
 1014  staff trainer for persons working in an assisted living facility
 1015  or another long-term care setting;
 1016         (g) Have at least 5 years of employment as a trainer of
 1017  core assisted living facility courses not directly associated
 1018  with the department;
 1019         (h) Have a 4-year baccalaureate degree from an accredited
 1020  college or university in the areas of health care, gerontology,
 1021  social work, education, or human services and at least 4 years
 1022  of experience as an educator or staff trainer for persons
 1023  working in an assisted living facility or another long-term care
 1024  setting after receiving certification in core courses; or
 1025         (i) Meet other qualification criteria as defined by rule of
 1026  the board.
 1027         (3)The board shall provide oversight of the assisted
 1028  living training providers. The board shall adopt rules to
 1029  establish requirements for trainer certification, disciplinary
 1030  action that may be taken against a trainer, and a trainer
 1031  decertification process.
 1032         (4) If funding is available, by January 1, 2013, the board
 1033  shall develop and maintain an electronic database, accessible to
 1034  the public, which lists all persons holding certification as an
 1035  assisted living trainer, including any history of violations.
 1036  Assisted living trainers shall keep a record of individuals who
 1037  complete training and shall submit the record to the board
 1038  within 24 hours after the completion of a course in order for
 1039  the board to include the information in the database.
 1040         Section 21. Section 429.523, Florida Statutes, is created
 1041  to read:
 1042         429.523Training and testing centers.—In addition to
 1043  certified assisted living trainers under s. 429.522, training
 1044  and testing centers approved by the board may conduct assisted
 1045  living training or examinations under this part.
 1046         (1) The board shall consider the following when reviewing a
 1047  center applicant:
 1048         (a)Whether the center will provide sufficient space for
 1049  training.
 1050         (b)The location of the center and whether another center
 1051  already provides assisted living training or testing in the
 1052  approximate area.
 1053         (c)The fee to be charged by the center for providing such
 1054  services.
 1055         (d) Whether the center has sufficient staff who meet the
 1056  qualifications for assisted living training providers under s.
 1057  429.522.
 1058         (e) Any other consideration that the board deems necessary
 1059  to approve a center.
 1060         (2) The board shall provide a certificate of approval to an
 1061  applicant that meets with the board’s approval. The training and
 1062  testing center shall keep the certificate on file as long as it
 1063  provides assisted living training or examination services.
 1064         (3) The board or the agency may inspect a center to
 1065  determine whether the training or testing center meets law and
 1066  rule requirements and may decertify a training and testing
 1067  center that does not continue to meet such requirements.
 1068         (4) An assisted living trainer employed by the training or
 1069  testing center must perform the recordkeeping and reporting
 1070  required under s. 429.522(4).
 1071         Section 22. Section 429.54, Florida Statutes, is amended to
 1072  read:
 1073         429.54 Collection of information; local subsidy;
 1074  interagency communication; facility reporting.—
 1075         (1) To enable the department to collect the information
 1076  requested by the Legislature regarding the actual cost of
 1077  providing room, board, and personal care in assisted living
 1078  facilities, the department may is authorized to conduct field
 1079  visits and audits of facilities as may be necessary. The owners
 1080  of randomly sampled facilities shall submit such reports,
 1081  audits, and accountings of cost as the department may require by
 1082  rule; however, provided that such reports, audits, and
 1083  accountings may not be more than shall be the minimum necessary
 1084  to implement the provisions of this subsection section. Any
 1085  facility selected to participate in the study shall cooperate
 1086  with the department by providing cost of operation information
 1087  to interviewers.
 1088         (2) Local governments or organizations may contribute to
 1089  the cost of care of local facility residents by further
 1090  subsidizing the rate of state-authorized payment to such
 1091  facilities. Implementation of local subsidy shall require
 1092  departmental approval and may shall not result in reductions in
 1093  the state supplement.
 1094         (3) Subject to the availability of funds, the agency, the
 1095  Department of Elderly Affairs, the Department of Children and
 1096  Family Services, and the Agency for Persons with Disabilities
 1097  shall develop or modify electronic systems of communication
 1098  among state-supported automated systems to ensure that relevant
 1099  information pertaining to the regulation of assisted living
 1100  facilities and facility staff is timely and effectively
 1101  communicated among agencies in order to facilitate the
 1102  protection of residents.
 1103         (4) All assisted living facilities shall submit twice a
 1104  year electronic reports to the agency.
 1105         (a) The reports must include the following information and
 1106  must be submitted in accordance with a reporting cycle
 1107  established by the agency by rule:
 1108         1. The number of beds in the facility;
 1109         2. The number of beds being occupied;
 1110         3. The number of residents who are younger than 65 years of
 1111  age, from 65 to 74 years of age, from 75 to 84 years of age, and
 1112  85 years of age or older;
 1113         4. The number of residents who are mental health residents,
 1114  who are receiving extended congregate care, who are receiving
 1115  limited nursing services, and who are receiving hospice care;
 1116         5. If there is a facility waiting list, the number of
 1117  individuals on the waiting list and the type of services or care
 1118  that they require, if known;
 1119         6. The number of residents receiving optional state
 1120  supplementation; and
 1121         7. The number of residents who are Medicaid recipients and
 1122  the type of waiver used to fund each such resident’s care.
 1123         (b) The agency must maintain electronically the information
 1124  it receives and, at a minimum, use such information to track
 1125  trends in resident populations and needs.
 1126         (c) This subsection expires July 1, 2017.
 1127         Section 23. Section 429.55, Florida Statutes, is created to
 1128  read:
 1129         429.55Assisted living facility rating system.—
 1130         (1) The agency, in consultation with the department, the
 1131  Department of Children and Family Services, and the Office of
 1132  State Long-Term Care Ombudsman, shall develop and adopt by rule
 1133  a user-friendly assisted living facility rating system.
 1134         (2) The rating system must be publicly available on the
 1135  Internet in order to assist consumers in evaluating assisted
 1136  living facilities and the services provided by such facilities.
 1137         (3) The rating system must be based on resident
 1138  satisfaction, the number and class of deficiencies for which the
 1139  facility has been cited, agency inspection reports, the
 1140  inspection reports of any other regulatory agency, assessments
 1141  conducted by the ombudsman program pursuant to part of chapter
 1142  400, and other criteria as determined by the agency.
 1143         (4) The Internet home page for the rating system must
 1144  include a link that allows consumers to complete a voluntary
 1145  survey that provides feedback on whether the rating system is
 1146  helpful and suggestions for improvement.
 1147         (5) The agency may adopt rules as necessary to administer
 1148  this section.
 1149         Section 24. The Division of Statutory Revision is requested
 1150  to rename part II of chapter 468, Florida Statutes, consisting
 1151  of ss. 468.1635-468.1756, Florida Statutes, as “Nursing Home and
 1152  Assisted Living Facility Administration.”
 1153         Section 25. Section 468.1635, Florida Statutes, is amended
 1154  to read:
 1155         468.1635 Purpose.—The sole legislative purpose for enacting
 1156  this part chapter is to ensure that every nursing home
 1157  administrator and assisted living facility administrator
 1158  practicing in this state meets minimum requirements for safe
 1159  practice. It is the legislative intent that nursing home
 1160  administrators and assisted living facility administrators who
 1161  fall below minimum competency or who otherwise present a danger
 1162  to the public shall be prohibited from practicing in this state.
 1163         Section 26. Section 468.1645, Florida Statutes, is amended
 1164  to read:
 1165         468.1645 Administrator license required.—
 1166         (1) A No nursing home in the state may not operate in this
 1167  state unless it is under the management of a nursing home
 1168  administrator, and, effective July 1, 2013, an assisted living
 1169  facility may not operate in this state unless it is under the
 1170  management of an assisted living facility administrator, who
 1171  holds a currently valid license, provisional license, or
 1172  temporary license.
 1173         (2) Nothing in this part or in the rules adopted hereunder
 1174  shall require an administrator of any facility or institution
 1175  operated by and for persons who rely exclusively upon treatment
 1176  by spiritual means through prayer, in accordance with the creed
 1177  or tenets of any organized church or religious denomination, to
 1178  be licensed as a nursing home or assisted living facility
 1179  administrator if the administrator is employed only to
 1180  administer in such facilities or institutions for the care and
 1181  treatment of the sick.
 1182         Section 27. Section 468.1655, Florida Statutes, is
 1183  reordered and amended to read:
 1184         468.1655 Definitions.—As used in this part:
 1185         (1)“Assisted living facility” means a facility licensed
 1186  under part I of chapter 429.
 1187         (2) “Assisted living facility administrator” means a person
 1188  who is licensed to engage in the practice of assisted living
 1189  facility administration in this state under the authority of
 1190  this part.
 1191         (3)(1) “Board” means the Board of Nursing Home and Assisted
 1192  Living Facility Administrators.
 1193         (4)(2) “Department” means the Department of Health.
 1194         (6)(3) “Nursing home administrator” means a person who is
 1195  licensed to engage in the practice of nursing home
 1196  administration in this state under the authority of this part.
 1197         (7)“Practice of assisted living facility administration”
 1198  means any service requiring assisted living facility
 1199  administration education, training, or experience and the
 1200  application of such to the planning, organizing, staffing,
 1201  directing, and controlling of the total management of an
 1202  assisted living facility. A person is practicing or offering to
 1203  practice assisted living facility administration if such person:
 1204         (a) Practices any of the above services.
 1205         (b) Holds himself or herself out as able to perform, or
 1206  does perform, any form of assisted living facility
 1207  administration by written or verbal claim, sign, advertisement,
 1208  letterhead, or card; or in any other way represents himself or
 1209  herself to be, or implies that he or she is, an assisted living
 1210  facility administrator.
 1211         (8)(4) “Practice of nursing home administration” means any
 1212  service requiring nursing home administration education,
 1213  training, or experience and the application of such to the
 1214  planning, organizing, staffing, directing, and controlling of
 1215  the total management of a nursing home. A person is practicing
 1216  or offering shall be construed to practice or to offer to
 1217  practice nursing home administration if such person who:
 1218         (a) Practices any of the above services.
 1219         (b) Holds himself or herself out as able to perform, or
 1220  does perform, any form of nursing home administration by written
 1221  or verbal claim, sign, advertisement, letterhead, or card; or in
 1222  any other way represents himself or herself to be, or implies
 1223  that he or she is, a nursing home administrator.
 1224         (5) “Nursing home” means an institution or facility
 1225  licensed as such under part II of chapter 400.
 1226         Section 28. Section 468.1665, Florida Statutes, is amended
 1227  to read:
 1228         468.1665  Board of Nursing Home and Assisted Living
 1229  Facility Administrators; membership; appointment; terms.—
 1230         (1) The Board of Nursing Home and Assisted Living Facility
 1231  Administrators is created within the department and shall
 1232  consist of eleven seven members, to be appointed by the Governor
 1233  and confirmed by the Senate to a term of 4 years or for a term
 1234  to complete an unexpired vacancy.
 1235         (2) Three members of the board must be licensed nursing
 1236  home administrators. Three members of the board must be licensed
 1237  assisted living facility administrators. Two members of the
 1238  board must be health care practitioners. Three The remaining two
 1239  members of the board must be laypersons who are not, and have
 1240  never been, nursing home or assisted living facility
 1241  administrators or members of any health care profession or
 1242  occupation, and at least one of these laypersons must be a
 1243  resident of an assisted living facility. At least one member of
 1244  the board must be 60 years of age or older.
 1245         (3) A person may not be appointed as a member of the board
 1246  if a conflict of interest exists, except that a nursing home
 1247  administrator or an assisted living facility administrator who
 1248  is appointed to the board may retain a financial interest in the
 1249  institution or facility he or she administers at the time of
 1250  appointment Only board members who are nursing home
 1251  administrators may have a direct financial interest in any
 1252  nursing home.
 1253         (4) All provisions of chapter 456 relating to activities of
 1254  regulatory boards shall apply.
 1255         Section 29. Section 468.1685, Florida Statutes, is amended
 1256  to read:
 1257         468.1685 Powers and duties of board and department.—It is
 1258  the function and duty of the board, together with the
 1259  department, to:
 1260         (1) Adopt rules pursuant to ss. 120.536(1) and 120.54 to
 1261  implement the provisions of this part conferring duties upon the
 1262  board.
 1263         (2) Develop, impose, and enforce specific standards within
 1264  the scope of the general qualifications established by this part
 1265  which must be met by individuals in order to receive licenses as
 1266  nursing home or assisted living facility administrators. These
 1267  standards shall be designed to ensure that nursing home and
 1268  assisted living facility administrators are individuals of good
 1269  character and otherwise suitable and, by training or experience
 1270  in the field of health care facility institutional
 1271  administration, qualified to serve as nursing home or assisted
 1272  living facility administrators.
 1273         (3) Develop by appropriate techniques, including
 1274  examinations and investigations, a method for determining
 1275  whether an individual meets such standards.
 1276         (4) Issue licenses to qualified individuals meeting the
 1277  standards of the board and revoke or suspend licenses previously
 1278  issued by the board if when the individual holding such license
 1279  is determined to have failed to conform substantially conform to
 1280  the requirements of such standards.
 1281         (5) Establish by rule and carry out procedures, by rule,
 1282  designed to ensure that licensed nursing home or assisted living
 1283  facility administrators will comply with the standards adopted
 1284  by the board.
 1285         (6) Receive, investigate, and take appropriate action with
 1286  respect to any charge or complaint filed with the department to
 1287  the effect that a licensed nursing home or assisted living
 1288  facility administrator has failed to comply with the
 1289  requirements or standards adopted by the board.
 1290         (7) Conduct a continuing study and investigation of nursing
 1291  homes and assisted living facilities and the administrators of
 1292  nursing homes and assisted living facilities in order to improve
 1293  the standards imposed for the licensing of such administrators
 1294  and the procedures and methods for enforcing such standards with
 1295  respect to licensed administrators of nursing homes who have
 1296  been licensed as such.
 1297         (8) Set up procedures by rule for advising and acting
 1298  together with the department Department of Health and other
 1299  boards of other health professions in matters affecting
 1300  procedures and methods for effectively enforcing the purpose of
 1301  this part and the administration of chapters 400 and 429.
 1302         (9) In consultation with the Agency for Health Care
 1303  Administration, the Department of Elderly Affairs, and the
 1304  Department of Children and Family Services, develop the
 1305  following which must be completed by an applicant for licensure
 1306  as an assisted living facility administrator:
 1307         (a) Assisted living facility administrator core training
 1308  that includes at least 40 hours of training, is offered in
 1309  English and Spanish, is reviewed at least annually by the board,
 1310  and updated as needed to reflect changes in the law, rules, and
 1311  best practices. The curriculum, at a minimum, must cover the
 1312  following topics:
 1313         1. State law and rules relating to assisted living
 1314  facilities.
 1315         2. Resident rights and the identification and reporting of
 1316  abuse, neglect, and exploitation.
 1317         3. The special needs of elderly persons, persons who have
 1318  mental illness, and persons who have developmental disabilities
 1319  and how to meet those needs.
 1320         4. Nutrition and food service, including acceptable
 1321  sanitation practices for preparing, storing, and serving food.
 1322         5. Medication management, recordkeeping, and proper
 1323  techniques for assisting residents who self-administer
 1324  medication.
 1325         6. Firesafety requirements, including procedures for fire
 1326  evacuation drills and other emergency procedures.
 1327         7. The care of persons who have Alzheimer’s disease and
 1328  related disorders.
 1329         8. Elopement prevention.
 1330         9. Aggression and behavior management, de-escalation
 1331  techniques, and proper protocols and procedures relating to the
 1332  Baker Act as provided in part I of chapter 394.
 1333         10. Do-not-resuscitate orders.
 1334         11. Infection control.
 1335         12. Admission and continued residency.
 1336         13. Phases of care and interacting with residents.
 1337         14. Best practices in the industry.
 1338         15. Business operations, including, but not limited to,
 1339  human resources, financial management, and supervision of staff.
 1340         (b) An assisted living facility administrator licensure
 1341  examination that tests the applicant’s knowledge and training of
 1342  the core training topics listed in paragraph (a). The
 1343  examination must be offered in English and Spanish, reviewed at
 1344  least annually by the board, and updated as needed to reflect
 1345  changes in the law, rules, and best practices. A minimum score
 1346  of 80 is required to demonstrate successful completion of the
 1347  training requirements.
 1348         (10) In consultation with the Agency for Health Care
 1349  Administration, the Department of Elderly Affairs, and the
 1350  Department of Children and Family Services, develop a continuing
 1351  education curriculum, for licensed assisted living facility
 1352  administrators. Administrators who are employed by extended
 1353  congregate care, limited nursing services, or limited mental
 1354  health licensees must complete additional credit hours as
 1355  determined by the board. The board shall also develop a short
 1356  examination that corresponds with each continuing education
 1357  course and must be offered in English and Spanish. The board
 1358  must review the continuing education curriculum and each
 1359  examination at least annually, and update the curriculum and
 1360  examinations as needed to reflect changes in the law, rules, and
 1361  best practices. Continuing education must include topics similar
 1362  to those of the core training in paragraph (9), and may include
 1363  additional subject matter that enhances the knowledge, skills,
 1364  and abilities of assisted living facility administrators, as
 1365  adopted by rule.
 1366         (11) In consultation with a panel of at least three mental
 1367  health professionals, develop a limited mental health curriculum
 1368  and examination, which must be completed by an assisted living
 1369  facility administrator within 30 days after being employed by a
 1370  limited mental health licensee. The examination must be offered
 1371  in English and Spanish and must be available online. The board
 1372  shall review the examination at least annually and update as
 1373  needed.
 1374         (12) In consultation with stakeholders, develop the
 1375  standardized staff training curriculum required under s. 429.52
 1376  for assisted living facility staff members, other than an
 1377  administrator, who provide regular or direct care to residents.
 1378  The curriculum must be reviewed at least annually by the board,
 1379  and updated as needed to reflect changes in the law, rules, and
 1380  best practices. The curriculum must include at least 20 hours of
 1381  inservice training, with at least 1 hour of training per topic,
 1382  covering at least the following topics:
 1383         (a) Reporting major incidents.
 1384         (b) Reporting adverse incidents.
 1385         (c) Facility emergency procedures, including chain-of
 1386  command and staff member roles relating to emergency evacuation.
 1387         (d)Resident rights in an assisted living facility.
 1388         (e) Recognizing and reporting resident abuse, neglect, and
 1389  exploitation.
 1390         (f) Resident behavior and needs.
 1391         (g) Providing assistance with the activities of daily
 1392  living.
 1393         (h) Infection control.
 1394         (i) Aggression and behavior management and deescalation
 1395  techniques.
 1396         (13) In consultation with the Agency for Health Care
 1397  Administration, the Department of Elderly Affairs, the
 1398  Department of Children and Family Services, and stakeholders,
 1399  develop the interactive online tutorial required under s. 429.52
 1400  which must be completed by assisted living facility staff
 1401  members who provide regular or direct care to assisted living
 1402  facility residents. The tutorial must be based on the training
 1403  required under subsection (12). The board must offer the
 1404  tutorial in English and Spanish and update the tutorial as
 1405  needed, but at least annually.
 1406         (14) In consultation with the Agency for Health Care
 1407  Administration, the Department of Elderly Affairs, and the
 1408  Department of Children and Family Services, develop the
 1409  continuing education curriculum required under s. 429.52 for
 1410  staff members of an assisted living facility who provide regular
 1411  or direct care to assisted living facility residents. The board
 1412  shall require additional credit hours for assisted living
 1413  facility staff who are employed by extended congregate care,
 1414  limited nursing services, or limited mental health licensees.
 1415  The board must review the continuing education curriculum at
 1416  least annually and update the curriculum as needed. Continuing
 1417  education must include topics similar to those listed in
 1418  subsection (12), and may include additional subject matter that
 1419  enhances the knowledge, skills, and abilities of assisted living
 1420  facility staff, as adopted by rule.
 1421         (15) In consultation with a panel of at least three mental
 1422  health professionals, develop the limited mental health
 1423  curriculum and online interactive tutorial required under s.
 1424  429.521(3) which must be completed by assisted living facility
 1425  staff, other than the administrator, who provide regular and
 1426  direct care to mental health residents. The board must ensure
 1427  that the tutorial is offered in English and Spanish, and must be
 1428  updated as needed, but at least annually.
 1429         (16) Require and provide, or cause to be provided, the
 1430  training or education of staff members of an assisted living
 1431  facility beyond that which is required under this part if the
 1432  board or department determines that there are problems in a
 1433  facility which could be reduced through specific staff training
 1434  or education.
 1435         (17) Certify assisted living training providers who meet
 1436  the qualifications under s. 429.522.
 1437         (18) Approve testing and training centers pursuant to s.
 1438  429.523.
 1439         Section 30. Subsection (2) of section 468.1695, Florida
 1440  Statutes, is amended and subsections (5) through (9) are added
 1441  to that section, to read:
 1442         468.1695 Licensure by examination.—
 1443         (2) The department shall examine each applicant for a
 1444  nursing home administrator license who the board certifies has
 1445  completed the application form and remitted an examination fee
 1446  set by the board not to exceed $250 and who:
 1447         (a)1. Holds a baccalaureate degree from an accredited
 1448  college or university and majored in health care administration
 1449  or has credit for at least 60 semester hours in subjects, as
 1450  prescribed by rule of the board, which prepare the applicant for
 1451  total management of a nursing home; and
 1452         2. Has fulfilled the requirements of a college-affiliated
 1453  or university-affiliated internship in nursing home
 1454  administration or of a 1,000-hour nursing home administrator-in
 1455  training program prescribed by the board; or
 1456         (b)1. Holds a baccalaureate degree from an accredited
 1457  college or university; and
 1458         2.a. Has fulfilled the requirements of a 2,000-hour nursing
 1459  home administrator-in-training program prescribed by the board;
 1460  or
 1461         b. Has 1 year of management experience allowing for the
 1462  application of executive duties and skills, including the
 1463  staffing, budgeting, and directing of resident care, dietary,
 1464  and bookkeeping departments within a skilled nursing facility,
 1465  hospital, hospice, assisted living facility with a minimum of 60
 1466  licensed beds, or geriatric residential treatment program and,
 1467  if such experience is not in a skilled nursing facility, has
 1468  fulfilled the requirements of a 1,000-hour nursing home
 1469  administrator-in-training program prescribed by the board.
 1470         (5) Any person desiring to be licensed as an assisted
 1471  living facility administrator must apply to the department to
 1472  take the licensure examination. The examination shall be given
 1473  at least two times a year and consists of, but is not limited
 1474  to, questions on the following subjects:
 1475         (a) State law and rules relating to assisted living
 1476  facilities.
 1477         (b) Resident rights and the identification and reporting of
 1478  abuse, neglect, and exploitation.
 1479         (c) The special needs of elderly persons, persons who have
 1480  mental illness, and persons who have developmental disabilities
 1481  and how to meet those needs.
 1482         (d) Nutrition and food service, including acceptable
 1483  sanitation practices for preparing, storing, and serving food.
 1484         (e) Medication management, recordkeeping, and proper
 1485  techniques for assisting residents who self-administer
 1486  medication.
 1487         (f) Firesafety requirements, including procedures for fire
 1488  evacuation drills and other emergency procedures.
 1489         (g) The care of persons who have Alzheimer’s disease and
 1490  related disorders.
 1491         (h) Elopement prevention.
 1492         (i) Aggression and behavior management, de-escalation
 1493  techniques, and proper protocols and procedures relating to the
 1494  Baker Act as provided in part I of chapter 394.
 1495         (j) Do-not-resuscitate orders.
 1496         (k) Infection control.
 1497         (l) Admission and continued residency.
 1498         (m) Phases of care and interacting with residents.
 1499         (n) Best practices in the industry.
 1500         (o) Business operations, including, but not limited to,
 1501  human resources, financial management, and supervision of staff.
 1502         (6) The department shall examine each applicant for an
 1503  assisted living facility administrator license who the board
 1504  certifies has completed the application form and remitted an
 1505  examination fee set by the board not to exceed $250 and who:
 1506         (a) Is at least 21 years old;
 1507         (b) Holds a 4-year baccalaureate degree from an accredited
 1508  college or university that includes some coursework in health
 1509  care, gerontology, or geriatrics; a 4-year baccalaureate degree
 1510  from an accredited college or university and at least 2 years of
 1511  experience in direct care in an assisted living facility or
 1512  nursing home; or a 2-year associate degree that includes
 1513  coursework in health care, gerontology, or geriatrics and at
 1514  least 2 years of experience in direct care in an assisted living
 1515  facility or nursing home;
 1516         (c) Has completed a least 40 hours of core training;
 1517         (d) Has passed the licensure examination in subsection (5)
 1518  with a minimum score of 80;
 1519         (e) Has completed background screening pursuant to s.
 1520  429.174; and
 1521         (f) Otherwise meets the requirements of this part and part
 1522  I of chapter 429.
 1523         (7) An assisted living facility administrator who is
 1524  continuously employed as a facility administrator, or a nursing
 1525  home administrator who is continuously employed as a nursing
 1526  home administrator, for at least the 2 years before July 1,
 1527  2012, is eligible for licensure as an assisted living facility
 1528  administrator without meeting the educational requirements of
 1529  this section or taking the licensure examination if:
 1530         (a) The core training under this part has been completed.
 1531         (b) All continuing education requirements have been
 1532  completed.
 1533         (c) The applicant was not the administrator of a facility
 1534  or nursing home that was cited for a class I or class II
 1535  violation within the 2 years before July 1, 2012.
 1536         (8) Other licensed professionals may be exempted from some
 1537  or all of the training requirements of this section to be
 1538  eligible for licensure as an assisted living facility
 1539  administrator, as determined by the board by rule.
 1540         (9) If an applicant for assisted living facility
 1541  administration licensure fails the licensure examination, the
 1542  applicant must wait at least 10 days before retaking it. If an
 1543  applicant fails the licensure examination three times, the
 1544  applicant must retake the initial core training before retaking
 1545  the examination.
 1546         Section 31. Subsection (1) of section 468.1705, Florida
 1547  Statutes, is amended to read:
 1548         468.1705 Licensure by endorsement; temporary license.—
 1549         (1) The department shall issue a nursing home administrator
 1550  license by endorsement to an any applicant who, upon applying to
 1551  the department and remitting a fee set by the board not to
 1552  exceed $500, demonstrates to the board that he or she:
 1553         (a) Meets one of the following requirements:
 1554         1. Holds a valid active license to practice nursing home
 1555  administration in another state of the United States if,
 1556  provided that the current requirements for licensure in that
 1557  state are substantially equivalent to, or more stringent than,
 1558  current requirements in this state; or
 1559         2. Meets the qualifications for licensure in s. 468.1695;
 1560  and
 1561         (b)1. Has successfully completed a national examination
 1562  which is substantially equivalent to, or more stringent than,
 1563  the examination given by the department;
 1564         2. Has passed an examination on the laws and rules of this
 1565  state governing the administration of nursing homes; and
 1566         3. Has worked as a fully licensed nursing home
 1567  administrator for 2 years within the 5-year period immediately
 1568  preceding the application by endorsement.
 1569         Section 32. Section 468.1725, Florida Statutes, is amended
 1570  to read:
 1571         468.1725 Inactive status.—An administrator’s license may
 1572  become inactive if an administrator applies for inactive
 1573  licensure status, does not pay licensure renewal fees on time,
 1574  or does not complete continuing education courses within the
 1575  requisite time.
 1576         (1) If a license becomes inactive because:
 1577         (a)The administrator applied for and was granted inactive
 1578  licensure status, he or she must pay a reactivation fee in order
 1579  to reactive the license.
 1580         (b) The administrator failed to timely pay licensure
 1581  renewal fees, the he or she must pay the biennial renewal fee, a
 1582  delinquency fee, and a reactivation fee.
 1583         (c) The administrator did not timely complete continuing
 1584  education requirements.
 1585         (1)Unless otherwise prescribed in law, the board shall
 1586  prescribe by rule continuing education requirements as a
 1587  condition of reactivating a license. The continuing education
 1588  requirements for reactivating a license may not exceed 20
 1589  classroom hours for each year the license was inactive, in
 1590  addition to completing completion of the number of hours
 1591  required for renewal on the date the license became inactive.
 1592  The board may not reactivate the license until he or she
 1593  completes the continuing education requirements and pays a
 1594  delinquency and reactivation fee
 1595         (2) The board shall adopt rules relating to application
 1596  procedures for inactive status, for the renewal of inactive
 1597  licenses, and for the reactivation of licenses. The board shall
 1598  prescribe by rule an application fee for inactive status, a
 1599  renewal fee for inactive status, a delinquency fee, and a fee
 1600  for the reactivation of a license. None of These fees may not
 1601  exceed the biennial renewal fee established by the board for an
 1602  active license.
 1603         (3) The department may not reactivate a license unless the
 1604  inactive or delinquent licensee has paid any applicable biennial
 1605  renewal or delinquency fee, or both, and a reactivation fee.
 1606         Section 33. Section 468.1735, Florida Statutes, is amended
 1607  to read:
 1608         468.1735 Provisional license.—The board may establish by
 1609  rule requirements for issuance of a provisional license. A
 1610  provisional license shall be issued only to fill a position of
 1611  nursing home administrator that unexpectedly becomes vacant due
 1612  to illness, sudden death of the administrator, or abandonment of
 1613  position and shall be issued for one single period as provided
 1614  by rule not to exceed 6 months. The department shall not issue a
 1615  provisional license to any applicant who is under investigation
 1616  in this state or another jurisdiction for an offense which would
 1617  constitute a violation of s. 468.1745, or s. 468.1755, or s.
 1618  429.55(4)(a), as applicable. Upon completion of the
 1619  investigation relating to a nursing home administrator, the
 1620  provisions of s. 468.1755 shall apply. The provisional license
 1621  may be issued to a person who does not meet all of the licensing
 1622  requirements established by this part, but the board shall by
 1623  rule establish minimal requirements to ensure protection of the
 1624  public health, safety, and welfare. The provisional license
 1625  shall be issued to the person who is designated as the
 1626  responsible person next in command in the event of the
 1627  administrator’s departure. The board may set an application fee
 1628  not to exceed $500 for a provisional license.
 1629         Section 34. Section 468.1745, Florida Statutes, is amended
 1630  to read:
 1631         468.1745 Prohibitions; penalties.—
 1632         (1) A No person may not shall:
 1633         (a) Practice nursing home administration unless the person
 1634  holds an active license to practice nursing home administration.
 1635         (b) Use the name or title “nursing home administrator” if
 1636  when the person has not been licensed pursuant to this part act.
 1637         (c) Present as his or her own the license of another.
 1638         (d) Give false or forged evidence to the board or a member
 1639  thereof for the purpose of obtaining a license.
 1640         (e) Use or attempt to use a nursing home administrator’s
 1641  license that which has been suspended or revoked.
 1642         (f) Knowingly employ unlicensed persons in the practice of
 1643  nursing home administration.
 1644         (g) Knowingly conceal information relative to violations of
 1645  this part.
 1646         (2) A person may not:
 1647         (a) Practice assisted living facility administration unless
 1648  the person holds an active license to practice assisted living
 1649  facility administration.
 1650         (b) Use the name or title “assisted living facility
 1651  administrator” if the person has not been licensed pursuant to
 1652  this part.
 1653         (c) Present as his or her own the license of another.
 1654         (d) Give false or forged evidence to the board or a member
 1655  thereof for the purpose of obtaining a license.
 1656         (e) Use or attempt to use an assisted living facility
 1657  administrator’s license that has been suspended or revoked.
 1658         (f) Knowingly employ unlicensed persons in the practice of
 1659  assisted living facility administration.
 1660         (g) Knowingly conceal information relative to violations of
 1661  this part.
 1662         (3)(2) Any person who violates the provisions of this
 1663  section is guilty of a misdemeanor of the second degree,
 1664  punishable as provided in s. 775.082 or s. 775.083.
 1665         Section 35. Section 468.1755, Florida Statutes, is amended
 1666  to read:
 1667         468.1755 Disciplinary proceedings.—
 1668         (1) The following acts constitute grounds for denial of a
 1669  nursing home administrator license or disciplinary action, as
 1670  specified in s. 456.072(2):
 1671         (a) Violation of any provision of s. 456.072(1) or s.
 1672  468.1745(1).
 1673         (b) Attempting to procure a license to practice nursing
 1674  home administration by bribery, by fraudulent misrepresentation,
 1675  or through an error of the department or the board.
 1676         (c) Having a license to practice nursing home
 1677  administration revoked, suspended, or otherwise acted against,
 1678  including the denial of licensure, by the licensing authority of
 1679  another state, territory, or country.
 1680         (d) Being convicted or found guilty, regardless of
 1681  adjudication, of a crime in any jurisdiction which relates to
 1682  the practice of nursing home administration or the ability to
 1683  practice nursing home administration. Any plea of nolo
 1684  contendere shall be considered a conviction for purposes of this
 1685  part.
 1686         (e) Making or filing a report or record which the licensee
 1687  knows to be false, intentionally failing to file a report or
 1688  record required by state or federal law, willfully impeding or
 1689  obstructing such filing, or inducing another person to impede or
 1690  obstruct such filing. Such reports or records shall include only
 1691  those which are signed in the capacity of a licensed nursing
 1692  home administrator.
 1693         (f) Authorizing the discharge or transfer of a resident for
 1694  a reason other than those provided in ss. 400.022 and 400.0255.
 1695         (g) Advertising goods or services in a manner which is
 1696  fraudulent, false, deceptive, or misleading in form or content.
 1697         (h) Fraud or deceit, negligence, incompetence, or
 1698  misconduct in the practice of nursing home administration.
 1699         (i) Violation of a lawful order of the board or department
 1700  previously entered in a disciplinary hearing or failing to
 1701  comply with a lawfully issued subpoena of the board or
 1702  department.
 1703         (j) Practicing with a revoked, suspended, inactive, or
 1704  delinquent license.
 1705         (k) Repeatedly acting in a manner inconsistent with the
 1706  health, safety, or welfare of the patients of the facility in
 1707  which he or she is the administrator.
 1708         (l) Being unable to practice nursing home administration
 1709  with reasonable skill and safety to patients by reason of
 1710  illness, drunkenness, use of drugs, narcotics, chemicals, or any
 1711  other material or substance or as a result of any mental or
 1712  physical condition. In enforcing this paragraph, upon a finding
 1713  of the State Surgeon General or his or her designee that
 1714  probable cause exists to believe that the licensee is unable to
 1715  serve as a nursing home administrator due to the reasons stated
 1716  in this paragraph, the department shall have the authority to
 1717  issue an order to compel the licensee to submit to a mental or
 1718  physical examination by a physician designated by the
 1719  department. If the licensee refuses to comply with such order,
 1720  the department’s order directing such examination may be
 1721  enforced by filing a petition for enforcement in the circuit
 1722  court where the licensee resides or serves as a nursing home
 1723  administrator. The licensee against whom the petition is filed
 1724  shall not be named or identified by initials in any public court
 1725  records or documents, and the proceedings shall be closed to the
 1726  public. The department shall be entitled to the summary
 1727  procedure provided in s. 51.011. A licensee affected under this
 1728  paragraph shall have the opportunity, at reasonable intervals,
 1729  to demonstrate that he or she can resume the competent practice
 1730  of nursing home administration with reasonable skill and safety
 1731  to patients.
 1732         (m) Willfully or repeatedly violating any of the provisions
 1733  of the law, code, or rules of the licensing or supervising
 1734  authority or agency of the state or political subdivision
 1735  thereof having jurisdiction of the operation and licensing of
 1736  nursing homes.
 1737         (n) Paying, giving, causing to be paid or given, or
 1738  offering to pay or to give to any person a commission or other
 1739  valuable consideration for the solicitation or procurement,
 1740  either directly or indirectly, of nursing home usage.
 1741         (o) Willfully permitting unauthorized disclosure of
 1742  information relating to a patient or his or her records.
 1743         (p) Discriminating with respect to patients, employees, or
 1744  staff on account of race, religion, color, sex, or national
 1745  origin.
 1746         (q) Failing to implement an ongoing quality assurance
 1747  program directed by an interdisciplinary team that meets at
 1748  least every other month.
 1749         (r) Violating any provision of this chapter or chapter 456,
 1750  or any rules adopted pursuant thereto.
 1751         (2) The board may enter an order denying nursing home
 1752  administrator licensure or imposing any of the penalties in s.
 1753  456.072(2) against any applicant for licensure or licensee who
 1754  is found guilty of violating any provision of subsection (1) of
 1755  this section or who is found guilty of violating any provision
 1756  of s. 456.072(1).
 1757         (3) The board may enter an order denying licensure or
 1758  license renewal and may suspend or revoke the license of an
 1759  assisted living facility administrator who is under
 1760  investigation for, or who has committed, in this state or
 1761  another jurisdiction, any of the following:
 1762         (a) Attempting to procure a license to practice assisted
 1763  living facility administration by bribery, fraudulent
 1764  misrepresentation, or through an error of the agency or the
 1765  board.
 1766         (b)Having an license to practice assisted living facility
 1767  administration revoked, suspended, or otherwise acted against,
 1768  including the denial of licensure by the licensing authority of
 1769  another state, territory, or country.
 1770         (c)Being convicted or found guilty of, or entered a plea
 1771  of nolo contendre, regardless of adjudication, to a crime in any
 1772  jurisdiction which relates to the practice of assisted living
 1773  facility administration.
 1774         (d)Making or filing a report or record that the licensee
 1775  knows to be false, intentionally failing to file a report or
 1776  record required by state or federal law, willfully impeding or
 1777  obstructing such filing, or inducing another person to impede or
 1778  obstruct such filing. Such reports or records include only those
 1779  that are signed in the capacity of a licensed assisted living
 1780  facility administrator.
 1781         (e)Advertising goods or services in a manner that is
 1782  fraudulent, false, deceptive, or misleading in form or content.
 1783         (f) Committing fraud or deceit or exhibiting negligence,
 1784  incompetence, or misconduct in the practice of assisted living
 1785  facility administration.
 1786         (g)Violating a lawful order of the board or agency
 1787  previously entered in a disciplinary hearing or failing to
 1788  comply with a lawfully issued subpoena of the board or agency.
 1789         (h)Repeatedly acting in a manner that is inconsistent with
 1790  the health, safety, or welfare of the residents of the assisted
 1791  living facility in which he or she is the administrator.
 1792         (i)Being unable to practice assisted living facility
 1793  administration with reasonable skill and safety to residents by
 1794  reason of illness, drunkenness, use of drugs, narcotics,
 1795  chemicals, or any other material or substance or as a result of
 1796  any mental or physical condition. To enforce this subparagraph,
 1797  upon a finding of the Secretary of Health Care Administration or
 1798  his or her designee that probable cause exists to believe that
 1799  the licensee is unable to serve as an assisted living facility
 1800  administrator due to the reasons stated in this subparagraph,
 1801  the agency may issue an order to compel the licensee to submit
 1802  to a mental or physical examination by a physician designated by
 1803  the agency. If the licensee refuses to comply with such order,
 1804  the order may be enforced by filing a petition for enforcement
 1805  in the circuit court where the licensee resides or serves as a
 1806  facility administrator. The licensee against whom the petition
 1807  is filed may not be named or identified by initials in any
 1808  public court records or documents and the proceedings shall be
 1809  closed to the public. The agency is entitled to the summary
 1810  procedure pursuant to s. 51.011. At reasonable intervals, the
 1811  licensee affected must be provided an opportunity to demonstrate
 1812  that he or she can resume the competent practice of assisted
 1813  living facility administration with reasonable skill and safety
 1814  to residents.
 1815         (j)Paying, giving, causing to be paid or given, or
 1816  offering to pay or to give to any person a commission or other
 1817  valuable consideration for the solicitation or procurement,
 1818  directly or indirectly, of assisted living facility usage.
 1819         (k)Willfully permitting unauthorized disclosure of
 1820  information relating to a resident or his or her records.
 1821         (l) Discriminating with respect to residents, employees, or
 1822  staff members on account of race, religion, sex, or national
 1823  origin.
 1824         (m) Violating any provision of this part, part II of
 1825  chapter 408, or rules adopted pursuant to this part.
 1826         (4) The board shall revoke the license of an assisted
 1827  living facility administrator who knowingly participates in
 1828  intentional misconduct, or engages in conduct that constitutes
 1829  gross negligence, and contributes to the death of a resident.
 1830         (5)(3) The department shall reissue the license of a
 1831  disciplined licensee upon certification by the board that the
 1832  disciplined licensee has complied with all of the terms and
 1833  conditions set forth in the final order.
 1834         Section 36. Section 468.1756, Florida Statutes, is amended
 1835  to read:
 1836         468.1756 Statute of limitations.—An administrative
 1837  complaint may only be filed pursuant to s. 456.073 for an act
 1838  listed in s. 468.1755(1)(c)-(q) within 4 years after from the
 1839  time of the incident giving rise to the complaint, or within 4
 1840  years after from the time the incident is discovered or should
 1841  have been discovered.
 1842         Section 37. Assisted living facility streamlining task
 1843  force.—
 1844         (1) The Agency for Health Care Administration shall create
 1845  a task force consisting of at least one representative from the
 1846  agency, the Department of Elderly Affairs, the Department of
 1847  Children and Family Services, the Department of Health, and the
 1848  Office of State Long-Term Care Ombudsman.
 1849         (2) The purpose of the task force is to determine whether
 1850  agencies currently have overlapping regulatory responsibilities
 1851  over assisted living facilities and whether increased efficiency
 1852  and effectiveness may be realized by transferring,
 1853  consolidating, eliminating, or modifying such oversight between
 1854  agencies.
 1855         (3) The task force shall meet at least three times and
 1856  submit a report to the Governor, the President of the Senate,
 1857  and the Speaker of the House of Representatives by January 1,
 1858  2013, which includes the task force’s findings and
 1859  recommendations pertaining to streamlining agency oversight and
 1860  improving the effectiveness of regulatory functions.
 1861         (4) The task force is terminated effective March 1, 2013.
 1862         Section 38. By January 1, 2013, the Agency for Health Care
 1863  Administration shall submit copies of all of its inspection
 1864  forms used to inspect assisted living facilities to the Office
 1865  of State Long-Term Care Ombudsman. The office shall create and
 1866  act as the chair of a task force of up to 11 members, consisting
 1867  of an ombudsman, one representative of a nonprofit assisted
 1868  living facility, one representative of a for-profit assisted
 1869  living facility, at least one resident or family member of a
 1870  resident, other stakeholders, and one representative of the
 1871  agency, the Department of Elderly Affairs, the Department of
 1872  Children and Family Services, and the Department of Health, to
 1873  review the inspection forms. The task force shall provide
 1874  recommendations, if any, to modify the forms in order to ensure
 1875  that inspections adequately assess whether the assisted living
 1876  facilities are in compliance with the law, meet the needs of
 1877  residents, and ensure resident safety. The task force must
 1878  provide its recommendations, including explanations of its
 1879  recommendations, to the agency within 90 days after receiving
 1880  the inspection forms. The task force is terminated July 1, 2013.
 1881         Section 39. This act shall take effect July 1, 2012.