Florida Senate - 2020 CS for SB 402
By the Committee on Health Policy; and Senator Harrell
588-01170-20 2020402c1
1 A bill to be entitled
2 An act relating to assisted living facilities;
3 amending s. 429.02, F.S.; defining and redefining
4 terms; amending s. 429.07, F.S.; clarifying that an
5 assisted living facility licensed to provide extended
6 congregate care services or limited nursing services
7 must maintain a written progress report on each person
8 receiving services from the facility’s staff;
9 conforming a cross-reference; amending s. 429.11,
10 F.S.; prohibiting a county or municipality from
11 issuing a business tax receipt, rather than an
12 occupational license, to a facility under certain
13 circumstances; amending s. 429.176, F.S.; amending
14 educational requirements for an administrator who is
15 replacing another administrator; amending s. 429.23,
16 F.S.; removing restrictions on the method by which a
17 facility may send a report to the Agency for Health
18 Care Administration; requiring the agency to send a
19 reminder to the facility 3 business days prior to the
20 deadline for submission of the full report; removing a
21 requirement that each facility file reports of
22 liability claims; amending s. 429.255, F.S.;
23 clarifying that the absence of an order not to
24 resuscitate does not preclude a physician from
25 withholding or withdrawing cardiopulmonary
26 resuscitation or use of an automated external
27 defibrillator; amending s. 429.256, F.S.; requiring a
28 person assisting with a resident’s self-administration
29 of medication to confirm that the medication is
30 intended for that resident and to orally advise the
31 resident of the medication name and purpose; amending
32 s. 429.26, F.S.; including medical examinations within
33 criteria used for admission to an assisted living
34 facility; providing specified criteria for
35 determination of appropriateness for admission and
36 continued residency at an assisted living facility;
37 defining the term “bedridden”; requiring that a
38 resident receive a medical examination within a
39 specified timeframe after admission to a facility;
40 requiring that such examination be recorded on a
41 specified form; providing limitations on the use of
42 such form; providing minimum requirements for such
43 form; conforming a provision to changes made by the
44 act; eliminating the role of the Department of Elderly
45 Affairs in certain provisions relating to the
46 placement of residents in assisted living facilities;
47 requiring a facility to notify a resident’s
48 representative or designee of the need for health care
49 services and to assist in making appointments for such
50 care and services under certain circumstances;
51 requiring the facility to arrange for necessary care
52 and services if no resident representative or designee
53 is available or responsive; removing provisions
54 relating to the retention of certain residents in a
55 facility; amending s. 429.28, F.S.; revising
56 residents’ rights relating to a safe and secure living
57 environment; amending s. 429.41, F.S.; revising
58 legislative intent; removing a provision to conform to
59 changes made by the act; removing a redundant
60 provision authorizing the Agency for Health Care
61 Administration to adopt certain rules; removing
62 provisions relating to firesafety requirements, which
63 are relocated to another section; requiring county
64 emergency management agencies, rather than local
65 emergency management agencies, to review and approve
66 or disapprove of a facility’s comprehensive emergency
67 management plan; requiring a facility to submit a
68 comprehensive emergency management plan to the county
69 emergency management agency within a specified
70 timeframe after its licensure; revising the criteria
71 under which a facility must be fully inspected;
72 revising standards for the care of residents provided
73 by a facility; prohibiting the use of geriatric chairs
74 and Posey restraints in facilities; authorizing other
75 physical restraints to be used under certain
76 conditions and in accordance with certain rules;
77 requiring the agency to establish resident elopement
78 drill requirements; requiring that elopement drills
79 include a review of a facility’s procedures to address
80 elopement; revising the criteria under which a
81 facility must be fully inspected; revising provisions
82 requiring the agency to adopt by rule key quality-of
83 care standards; creating s. 429.435, F.S.; revising
84 uniform firesafety standards for assisted living
85 facilities, which are relocated to this section;
86 amending s. 429.52, F.S.; revising provisions relating
87 to facility staff training and educational
88 requirements; requiring the agency, in conjunction
89 with providers, to establish core training
90 requirements for facility administrators; revising
91 continuing education requirements for facility staff
92 who assist residents with the self-administration of
93 medications; revising the training requirements for
94 facility staff; revising provisions relating to the
95 training responsibilities of the agency; requiring the
96 agency to contract with another entity to administer a
97 certain competency test; requiring the department to
98 adopt a curriculum outline to be used by core
99 trainers; providing an effective date.
100
101 Be It Enacted by the Legislature of the State of Florida:
102
103 Section 1. Present subsections (1) through (5), (6) through
104 (10), (11) through (15), and (16) through (27) of section
105 429.02, Florida Statutes, are redesignated as subsections (2)
106 through (6), (8) through (12), (14) through (18), and (20)
107 through (31), respectively, new subsections (1), (7), (13), and
108 (19) are added, and present subsections (11) and (18) of that
109 section are amended, to read:
110 429.02 Definitions.—When used in this part, the term:
111 (1) “Abuse” has the same meaning as in s. 415.102.
112 (7) “Assistive device” means any device designed or adapted
113 to help a resident perform an action, a task, an activity of
114 daily living, or a transfer; prevent a fall; or recover from a
115 fall. The term does not include a total body lift or a motorized
116 sit-to-stand lift, with the exception of a chair lift or
117 recliner lift that a resident is able to operate independently.
118 (13) “Exploitation” has the same meaning as in s. 415.102.
119 (14)(11) “Extended congregate care” means acts beyond those
120 authorized in subsection (21) which (17) that may be performed
121 pursuant to part I of chapter 464 by persons licensed thereunder
122 while carrying out their professional duties, and other
123 supportive services that which may be specified by rule. The
124 purpose of such services is to enable residents to age in place
125 in a residential environment despite mental or physical
126 limitations that might otherwise disqualify them from residency
127 in a facility licensed under this part.
128 (19) “Neglect” has the same meaning as in s. 415.102. For
129 purposes other than reporting requirements within this part,
130 “neglect” may also include the failure to prevent sexual abuse
131 as defined in s. 415.102.
132 (22)(18) “Physical restraint” means a device that which
133 physically limits, restricts, or deprives an individual of
134 movement or mobility, including, but not limited to, a half-bed
135 rail, a full-bed rail, a geriatric chair, and a posey restraint.
136 The term “physical restraint” shall also include any device that
137 is which was not specifically manufactured as a restraint but is
138 which has been altered, arranged, or otherwise used for that
139 this purpose. The term does shall not include any device that
140 the resident chooses to use and is able to remove or avoid
141 independently, or any bandage material used for the purpose of
142 binding a wound or injury.
143 Section 2. Paragraphs (b) and (c) of subsection (3) of
144 section 429.07, Florida Statutes, are amended to read:
145 429.07 License required; fee.—
146 (3) In addition to the requirements of s. 408.806, each
147 license granted by the agency must state the type of care for
148 which the license is granted. Licenses shall be issued for one
149 or more of the following categories of care: standard, extended
150 congregate care, limited nursing services, or limited mental
151 health.
152 (b) An extended congregate care license shall be issued to
153 each facility that has been licensed as an assisted living
154 facility for 2 or more years and that provides services,
155 directly or through contract, beyond those authorized in
156 paragraph (a), including services performed by persons licensed
157 under part I of chapter 464 and supportive services, as defined
158 by rule, to persons who would otherwise be disqualified from
159 continued residence in a facility licensed under this part. An
160 extended congregate care license may be issued to a facility
161 that has a provisional extended congregate care license and
162 meets the requirements for licensure under subparagraph 2. The
163 primary purpose of extended congregate care services is to allow
164 residents the option of remaining in a familiar setting from
165 which they would otherwise be disqualified for continued
166 residency as they become more impaired. A facility licensed to
167 provide extended congregate care services may also admit an
168 individual who exceeds the admission criteria for a facility
169 with a standard license, if he or she is determined appropriate
170 for admission to the extended congregate care facility.
171 1. In order for extended congregate care services to be
172 provided, the agency must first determine that all requirements
173 established in law and rule are met and must specifically
174 designate, on the facility’s license, that such services may be
175 provided and whether the designation applies to all or part of
176 the facility. This designation may be made at the time of
177 initial licensure or relicensure, or upon request in writing by
178 a licensee under this part and part II of chapter 408. The
179 notification of approval or the denial of the request shall be
180 made in accordance with part II of chapter 408. Each existing
181 facility that qualifies to provide extended congregate care
182 services must have maintained a standard license and may not
183 have been subject to administrative sanctions during the
184 previous 2 years, or since initial licensure if the facility has
185 been licensed for less than 2 years, for any of the following
186 reasons:
187 a. A class I or class II violation;
188 b. Three or more repeat or recurring class III violations
189 of identical or similar resident care standards from which a
190 pattern of noncompliance is found by the agency;
191 c. Three or more class III violations that were not
192 corrected in accordance with the corrective action plan approved
193 by the agency;
194 d. Violation of resident care standards which results in
195 requiring the facility to employ the services of a consultant
196 pharmacist or consultant dietitian;
197 e. Denial, suspension, or revocation of a license for
198 another facility licensed under this part in which the applicant
199 for an extended congregate care license has at least 25 percent
200 ownership interest; or
201 f. Imposition of a moratorium pursuant to this part or part
202 II of chapter 408 or initiation of injunctive proceedings.
203
204 The agency may deny or revoke a facility’s extended congregate
205 care license for not meeting the criteria for an extended
206 congregate care license as provided in this subparagraph.
207 2. If an assisted living facility has been licensed for
208 less than 2 years, the initial extended congregate care license
209 must be provisional and may not exceed 6 months. The licensee
210 shall notify the agency, in writing, when it has admitted at
211 least one extended congregate care resident, after which an
212 unannounced inspection shall be made to determine compliance
213 with the requirements of an extended congregate care license. A
214 licensee with a provisional extended congregate care license
215 which that demonstrates compliance with all the requirements of
216 an extended congregate care license during the inspection shall
217 be issued an extended congregate care license. In addition to
218 sanctions authorized under this part, if violations are found
219 during the inspection and the licensee fails to demonstrate
220 compliance with all assisted living facility requirements during
221 a followup inspection, the licensee shall immediately suspend
222 extended congregate care services, and the provisional extended
223 congregate care license expires. The agency may extend the
224 provisional license for not more than 1 month in order to
225 complete a followup visit.
226 3. A facility that is licensed to provide extended
227 congregate care services shall maintain a written progress
228 report on each person who receives services from the facility’s
229 staff which describes the type, amount, duration, scope, and
230 outcome of services that are rendered and the general status of
231 the resident’s health. A registered nurse, or appropriate
232 designee, representing the agency shall visit the facility at
233 least twice a year to monitor residents who are receiving
234 extended congregate care services and to determine if the
235 facility is in compliance with this part, part II of chapter
236 408, and relevant rules. One of the visits may be in conjunction
237 with the regular survey. The monitoring visits may be provided
238 through contractual arrangements with appropriate community
239 agencies. A registered nurse shall serve as part of the team
240 that inspects the facility. The agency may waive one of the
241 required yearly monitoring visits for a facility that has:
242 a. Held an extended congregate care license for at least 24
243 months;
244 b. No class I or class II violations and no uncorrected
245 class III violations; and
246 c. No ombudsman council complaints that resulted in a
247 citation for licensure.
248 4. A facility that is licensed to provide extended
249 congregate care services must:
250 a. Demonstrate the capability to meet unanticipated
251 resident service needs.
252 b. Offer a physical environment that promotes a homelike
253 setting, provides for resident privacy, promotes resident
254 independence, and allows sufficient congregate space as defined
255 by rule.
256 c. Have sufficient staff available, taking into account the
257 physical plant and firesafety features of the building, to
258 assist with the evacuation of residents in an emergency.
259 d. Adopt and follow policies and procedures that maximize
260 resident independence, dignity, choice, and decisionmaking to
261 permit residents to age in place, so that moves due to changes
262 in functional status are minimized or avoided.
263 e. Allow residents or, if applicable, a resident’s
264 representative, designee, surrogate, guardian, or attorney in
265 fact to make a variety of personal choices, participate in
266 developing service plans, and share responsibility in
267 decisionmaking.
268 f. Implement the concept of managed risk.
269 g. Provide, directly or through contract, the services of a
270 person licensed under part I of chapter 464.
271 h. In addition to the training mandated in s. 429.52,
272 provide specialized training as defined by rule for facility
273 staff.
274 5. A facility that is licensed to provide extended
275 congregate care services is exempt from the criteria for
276 continued residency set forth in rules adopted under s. 429.41.
277 A licensed facility must adopt its own requirements within
278 guidelines for continued residency set forth by rule. However,
279 the facility may not serve residents who require 24-hour nursing
280 supervision. A licensed facility that provides extended
281 congregate care services must also provide each resident with a
282 written copy of facility policies governing admission and
283 retention.
284 6. Before the admission of an individual to a facility
285 licensed to provide extended congregate care services, the
286 individual must undergo a medical examination as provided in s.
287 429.26(5) s. 429.26(4) and the facility must develop a
288 preliminary service plan for the individual.
289 7. If a facility can no longer provide or arrange for
290 services in accordance with the resident’s service plan and
291 needs and the facility’s policy, the facility must make
292 arrangements for relocating the person in accordance with s.
293 429.28(1)(k).
294 (c) A limited nursing services license shall be issued to a
295 facility that provides services beyond those authorized in
296 paragraph (a) and as specified in this paragraph.
297 1. In order for limited nursing services to be provided in
298 a facility licensed under this part, the agency must first
299 determine that all requirements established in law and rule are
300 met and must specifically designate, on the facility’s license,
301 that such services may be provided. This designation may be made
302 at the time of initial licensure or licensure renewal, or upon
303 request in writing by a licensee under this part and part II of
304 chapter 408. Notification of approval or denial of such request
305 shall be made in accordance with part II of chapter 408. An
306 existing facility that qualifies to provide limited nursing
307 services must have maintained a standard license and may not
308 have been subject to administrative sanctions that affect the
309 health, safety, and welfare of residents for the previous 2
310 years or since initial licensure if the facility has been
311 licensed for less than 2 years.
312 2. A facility that is licensed to provide limited nursing
313 services shall maintain a written progress report on each person
314 who receives such nursing services from the facility’s staff.
315 The report must describe the type, amount, duration, scope, and
316 outcome of services that are rendered and the general status of
317 the resident’s health. A registered nurse representing the
318 agency shall visit the facility at least annually to monitor
319 residents who are receiving limited nursing services and to
320 determine if the facility is in compliance with applicable
321 provisions of this part, part II of chapter 408, and related
322 rules. The monitoring visits may be provided through contractual
323 arrangements with appropriate community agencies. A registered
324 nurse shall also serve as part of the team that inspects such
325 facility. Visits may be in conjunction with other agency
326 inspections. The agency may waive the required yearly monitoring
327 visit for a facility that has:
328 a. Had a limited nursing services license for at least 24
329 months;
330 b. No class I or class II violations and no uncorrected
331 class III violations; and
332 c. No ombudsman council complaints that resulted in a
333 citation for licensure.
334 3. A person who receives limited nursing services under
335 this part must meet the admission criteria established by the
336 agency for assisted living facilities. When a resident no longer
337 meets the admission criteria for a facility licensed under this
338 part, arrangements for relocating the person shall be made in
339 accordance with s. 429.28(1)(k), unless the facility is licensed
340 to provide extended congregate care services.
341 Section 3. Subsection (7) of section 429.11, Florida
342 Statutes, is amended to read:
343 429.11 Initial application for license; provisional
344 license.—
345 (7) A county or municipality may not issue a business tax
346 receipt an occupational license that is being obtained for the
347 purpose of operating a facility regulated under this part
348 without first ascertaining that the applicant has been licensed
349 to operate such facility at the specified location or locations
350 by the agency. The agency shall furnish to local agencies
351 responsible for issuing business tax receipts occupational
352 licenses sufficient instruction for making such determinations.
353 Section 4. Section 429.176, Florida Statutes, is amended to
354 read:
355 429.176 Notice of change of administrator.—If, during the
356 period for which a license is issued, the owner changes
357 administrators, the owner must notify the agency of the change
358 within 10 days and provide documentation within 90 days that the
359 new administrator meets educational requirements and has
360 completed the applicable core educational requirements under s.
361 429.52. A facility may not be operated for more than 120
362 consecutive days without an administrator who has completed the
363 core educational requirements.
364 Section 5. Subsections (2) through (5) of section 429.23,
365 Florida Statutes, are amended to read:
366 429.23 Internal risk management and quality assurance
367 program; adverse incidents and reporting requirements.—
368 (2) Every facility licensed under this part is required to
369 maintain adverse incident reports. For purposes of this section,
370 the term, “adverse incident” means:
371 (a) An event over which facility personnel could exercise
372 control which is associated with the facility’s intervention,
373 rather than as a result of the resident’s underlying disease or
374 condition, and the injury results in:
375 1. Death;
376 2. Brain or spinal damage;
377 3. Permanent disfigurement;
378 4. Fracture or dislocation of bones or joints;
379 5. Any condition that required medical attention to which
380 the resident has not given his or her consent, including failure
381 to honor advanced directives;
382 6. Any condition that requires the transfer of the resident
383 from the facility to a unit providing more acute care due to the
384 incident rather than the resident’s condition before the
385 incident; or
386 7. A report made An event that is reported to law
387 enforcement or its personnel for investigation; or
388 (b) Resident elopement, if the elopement places the
389 resident at risk of harm or injury.
390 (3) Licensed facilities shall provide within 1 business day
391 after the occurrence of an adverse incident, by electronic mail,
392 facsimile, or United States mail, a preliminary report to the
393 agency on all adverse incidents specified under this section.
394 The report must include information regarding the identity of
395 the affected resident, the type of adverse incident, and the
396 result status of the facility’s investigation of the incident.
397 (4) Licensed facilities shall provide within 15 days, by
398 electronic mail, facsimile, or United States mail, a full report
399 to the agency on all adverse incidents specified in this
400 section. The report must include the results of the facility’s
401 investigation into the adverse incident.
402 (5) The agency shall send, by electronic mail, reminders to
403 the facility’s administrator and other specified facility
404 contacts 3 business days before the deadline for the submission
405 of the full report. If the facility determines that the event is
406 not an adverse incident, the facility must withdraw the
407 preliminary report. Until 3 business days after the agency
408 provides the reminder, facilities shall not be subject to any
409 administrative or other action for failing to file a full report
410 if the facility determined that the event was not an adverse
411 incident after filing the preliminary report. Each facility
412 shall report monthly to the agency any liability claim filed
413 against it. The report must include the name of the resident,
414 the dates of the incident leading to the claim, if applicable,
415 and the type of injury or violation of rights alleged to have
416 occurred. This report is not discoverable in any civil or
417 administrative action, except in such actions brought by the
418 agency to enforce the provisions of this part.
419 Section 6. Subsection (4) of section 429.255, Florida
420 Statutes, is amended to read:
421 429.255 Use of personnel; emergency care.—
422 (4) Facility staff may withhold or withdraw cardiopulmonary
423 resuscitation or the use of an automated external defibrillator
424 if presented with an order not to resuscitate executed pursuant
425 to s. 401.45. The agency shall adopt rules providing for the
426 implementation of such orders. Facility staff and facilities may
427 not be subject to criminal prosecution or civil liability, nor
428 be considered to have engaged in negligent or unprofessional
429 conduct, for withholding or withdrawing cardiopulmonary
430 resuscitation or use of an automated external defibrillator
431 pursuant to such an order and rules adopted by the agency. The
432 absence of an order not to resuscitate executed pursuant to s.
433 401.45 does not preclude a physician from withholding or
434 withdrawing cardiopulmonary resuscitation or use of an automated
435 external defibrillator as otherwise permitted by law.
436 Section 7. Subsection (2), paragraph (b) of subsection (3),
437 and paragraphs (e), (f), and (g) of subsection (4) of section
438 429.256, Florida Statutes, are amended to read:
439 429.256 Assistance with self-administration of medication.—
440 (2) Residents who are capable of self-administering their
441 own medications without assistance shall be encouraged and
442 allowed to do so. However, an unlicensed person may, consistent
443 with a dispensed prescription’s label or the package directions
444 of an over-the-counter medication, assist a resident whose
445 condition is medically stable with the self-administration of
446 routine, regularly scheduled medications that are intended to be
447 self-administered. Assistance with self-medication by an
448 unlicensed person may occur only upon a documented request by,
449 and the written informed consent of, a resident or the
450 resident’s surrogate, guardian, or attorney in fact. For the
451 purposes of this section, self-administered medications include
452 both legend and over-the-counter oral dosage forms, topical
453 dosage forms, transdermal patches, and topical ophthalmic, otic,
454 and nasal dosage forms including solutions, suspensions, sprays,
455 and inhalers.
456 (3) Assistance with self-administration of medication
457 includes:
458 (b) In the presence of the resident, confirming that the
459 medication is intended for that resident, orally advising the
460 resident of the medication name and purpose reading the label,
461 opening the container, removing a prescribed amount of
462 medication from the container, and closing the container.
463 (4) Assistance with self-administration does not include:
464 (e) The use of irrigations or debriding agents used in the
465 treatment of a skin condition.
466 (f) Assisting with rectal, urethral, or vaginal
467 preparations.
468 (g) Assisting with medications ordered by the physician or
469 health care professional with prescriptive authority to be given
470 “as needed,” unless the order is written with specific
471 parameters that preclude independent judgment on the part of the
472 unlicensed person, and at the request of a competent resident
473 requesting the medication is aware of his or her need for the
474 medication and understands the purpose for taking the
475 medication.
476 Section 8. Section 429.26, Florida Statutes, is amended to
477 read:
478 429.26 Appropriateness of placements; examinations of
479 residents.—
480 (1) The owner or administrator of a facility is responsible
481 for determining the appropriateness of admission of an
482 individual to the facility and for determining the continued
483 appropriateness of residence of an individual in the facility. A
484 determination must shall be based upon an evaluation assessment
485 of the strengths, needs, and preferences of the resident, a
486 medical examination, the care and services offered or arranged
487 for by the facility in accordance with facility policy, and any
488 limitations in law or rule related to admission criteria or
489 continued residency for the type of license held by the facility
490 under this part. The following criteria apply to the
491 determination of appropriateness for admission and continued
492 residency of an individual in a facility:
493 (a) A facility may admit or retain a resident who receives
494 a health care service or treatment that is designed to be
495 provided within a private residential setting if all
496 requirements for providing that service or treatment are met by
497 the facility or a third party.
498 (b) A facility may admit or retain a resident who requires
499 the use of assistive devices.
500 (c) A facility may admit or retain an individual receiving
501 hospice services if the arrangement is agreed to by the facility
502 and the resident, additional care is provided by a licensed
503 hospice, and the resident is under the care of a physician who
504 agrees that the physical needs of the resident can be met at the
505 facility. The resident must have a plan of care which delineates
506 how the facility and the hospice will meet the scheduled and
507 unscheduled needs of the resident.
508 (d)1. Except for a resident who is receiving hospice
509 services as provided in paragraph (c), a facility may not admit
510 or retain a resident who is bedridden or who requires 24-hour
511 nursing supervision. For purposes of this paragraph, the term
512 “bedridden” means that a resident is confined to a bed because
513 of the inability to:
514 a. Move, turn, or reposition without total physical
515 assistance;
516 b. Transfer to a chair or wheelchair without total physical
517 assistance; or
518 c. Sit safely in a chair or wheelchair without personal
519 assistance or a physical restraint.
520 2. A resident may continue to reside in a facility if,
521 during residency, he or she is bedridden for no more than 7
522 consecutive days.
523 3. If a facility is licensed to provide extended congregate
524 care, a resident may continue to reside in a facility if, during
525 residency, he or she is bedridden for no more than 14
526 consecutive days.
527 (2) A resident may not be moved from one facility to
528 another without consultation with and agreement from the
529 resident or, if applicable, the resident’s representative or
530 designee or the resident’s family, guardian, surrogate, or
531 attorney in fact. In the case of a resident who has been placed
532 by the department or the Department of Children and Families,
533 the administrator must notify the appropriate contact person in
534 the applicable department.
535 (3)(2) A physician, physician assistant, or advanced
536 practice registered nurse practitioner who is employed by an
537 assisted living facility to provide an initial examination for
538 admission purposes may not have financial interests interest in
539 the facility.
540 (4)(3) Persons licensed under part I of chapter 464 who are
541 employed by or under contract with a facility shall, on a
542 routine basis or at least monthly, perform a nursing assessment
543 of the residents for whom they are providing nursing services
544 ordered by a physician, except administration of medication, and
545 shall document such assessment, including any substantial
546 changes in a resident’s status which may necessitate relocation
547 to a nursing home, hospital, or specialized health care
548 facility. Such records shall be maintained in the facility for
549 inspection by the agency and shall be forwarded to the
550 resident’s case manager, if applicable.
551 (5)(4) If possible, Each resident must shall have been
552 examined by a licensed physician, a licensed physician
553 assistant, or a licensed advanced practice registered nurse
554 practitioner within 60 days before admission to the facility or
555 within 30 days after admission to the facility, except as
556 provided in s. 429.07. The information from the medical
557 examination must be recorded on the practitioner’s form or on a
558 form adopted by agency rule. The signed and completed medical
559 examination form, signed by the practitioner, must report shall
560 be submitted to the owner or administrator of the facility, who
561 shall use the information contained therein to assist in the
562 determination of the appropriateness of the resident’s admission
563 to or and continued residency stay in the facility. The medical
564 examination form may be used only to record the health care
565 provider’s direct observation of the patient at the time of
566 examination and must include any known medical history. The
567 medical examination form is not a guarantee of admission,
568 continued residency, or the delivery of services and may be used
569 only as an informative tool to assist in the determination of
570 the appropriateness of the resident’s admission to or continued
571 residency in the facility. The medical examination form,
572 reflecting the resident’s condition on the date the examination
573 is performed, becomes report shall become a permanent part of
574 the facility’s record of the resident at the facility and must
575 shall be made available to the agency during inspection or upon
576 request. An assessment that has been completed through the
577 Comprehensive Assessment and Review for Long-Term Care Services
578 (CARES) Program fulfills the requirements for a medical
579 examination under this subsection and s. 429.07(3)(b)6.
580 (6) The medical examination form submitted under subsection
581 (5) must include the following information relating to the
582 resident:
583 (a) Height, weight, and known allergies.
584 (b) Significant medical history and diagnoses.
585 (c) Physical or sensory limitations, including the need for
586 fall precautions or recommended use of assistive devices.
587 (d) Cognitive or behavioral status and a brief description
588 of any behavioral issues known or ascertained by the examining
589 practitioner, including any known history of wandering or
590 elopement.
591 (e) Nursing, treatment, or therapy service requirements.
592 (f) Whether assistance is needed for ambulating, eating, or
593 transferring.
594 (g) Special dietary instructions.
595 (h) Whether he or she has any communicable diseases,
596 including necessary precautions.
597 (i) Whether he or she is bedridden and the status of any
598 pressure sores that he or she has.
599 (j) Whether the resident needs 24-hour nursing supervision
600 or psychiatric care.
601 (k) A list of current prescribed medications as known or
602 ascertained by the examining practitioner and whether the
603 resident can self-administer medications, needs assistance, or
604 needs medication administration.
605 (5) Except as provided in s. 429.07, if a medical
606 examination has not been completed within 60 days before the
607 admission of the resident to the facility, a licensed physician,
608 licensed physician assistant, or licensed nurse practitioner
609 shall examine the resident and complete a medical examination
610 form provided by the agency within 30 days following the
611 admission to the facility to enable the facility owner or
612 administrator to determine the appropriateness of the admission.
613 The medical examination form shall become a permanent part of
614 the record of the resident at the facility and shall be made
615 available to the agency during inspection by the agency or upon
616 request.
617 (7)(6) Any resident accepted in a facility and placed by
618 the department or the Department of Children and Families must
619 shall have been examined by medical personnel within 30 days
620 before placement in the facility. The examination must shall
621 include an assessment of the appropriateness of placement in a
622 facility. The findings of this examination must shall be
623 recorded on the examination form provided by the agency. The
624 completed form must shall accompany the resident and shall be
625 submitted to the facility owner or administrator. Additionally,
626 in the case of a mental health resident, the Department of
627 Children and Families must provide documentation that the
628 individual has been assessed by a psychiatrist, clinical
629 psychologist, clinical social worker, or psychiatric nurse, or
630 an individual who is supervised by one of these professionals,
631 and determined to be appropriate to reside in an assisted living
632 facility. The documentation must be in the facility within 30
633 days after the mental health resident has been admitted to the
634 facility. An evaluation completed upon discharge from a state
635 mental hospital meets the requirements of this subsection
636 related to appropriateness for placement as a mental health
637 resident provided that providing it was completed within 90 days
638 prior to admission to the facility. The applicable Department of
639 Children and Families shall provide to the facility
640 administrator any information about the resident which that
641 would help the administrator meet his or her responsibilities
642 under subsection (1). Further, Department of Children and
643 Families personnel shall explain to the facility operator any
644 special needs of the resident and advise the operator whom to
645 call should problems arise. The applicable Department of
646 Children and Families shall advise and assist the facility
647 administrator when where the special needs of residents who are
648 recipients of optional state supplementation require such
649 assistance.
650 (8)(7) The facility shall must notify a licensed physician
651 when a resident exhibits signs of dementia or cognitive
652 impairment or has a change of condition in order to rule out the
653 presence of an underlying physiological condition that may be
654 contributing to such dementia or impairment. The notification
655 must occur within 30 days after the acknowledgment of such signs
656 by facility staff. If an underlying condition is determined to
657 exist, the facility must notify the resident’s representative or
658 designee of the need for health care services and must assist in
659 making appointments for shall arrange, with the appropriate
660 health care provider, the necessary care and services to treat
661 the condition. If the resident does not have a representative or
662 designee or if the resident’s representative or designee cannot
663 be located or is unresponsive, the facility shall arrange, with
664 the appropriate health care provider, the necessary care and
665 services to treat the condition.
666 (9)(8) The Department of Children and Families may require
667 an examination for supplemental security income and optional
668 state supplementation recipients residing in facilities at any
669 time and shall provide the examination whenever a resident’s
670 condition requires it. Any facility administrator; personnel of
671 the agency, the department, or the Department of Children and
672 Families; or a representative of the State Long-Term Care
673 Ombudsman Program who believes a resident needs to be evaluated
674 shall notify the resident’s case manager, who shall take
675 appropriate action. A report of the examination findings must
676 shall be provided to the resident’s case manager and the
677 facility administrator to help the administrator meet his or her
678 responsibilities under subsection (1).
679 (9) A terminally ill resident who no longer meets the
680 criteria for continued residency may remain in the facility if
681 the arrangement is mutually agreeable to the resident and the
682 facility; additional care is rendered through a licensed
683 hospice, and the resident is under the care of a physician who
684 agrees that the physical needs of the resident are being met.
685 (10) Facilities licensed to provide extended congregate
686 care services shall promote aging in place by determining
687 appropriateness of continued residency based on a comprehensive
688 review of the resident’s physical and functional status; the
689 ability of the facility, family members, friends, or any other
690 pertinent individuals or agencies to provide the care and
691 services required; and documentation that a written service plan
692 consistent with facility policy has been developed and
693 implemented to ensure that the resident’s needs and preferences
694 are addressed.
695 (11) No resident who requires 24-hour nursing supervision,
696 except for a resident who is an enrolled hospice patient
697 pursuant to part IV of chapter 400, shall be retained in a
698 facility licensed under this part.
699 Section 9. Paragraphs (a) and (k) of subsection (1) and
700 subsection (3) of section 429.28, Florida Statutes, are amended
701 to read:
702 429.28 Resident bill of rights.—
703 (1) No resident of a facility shall be deprived of any
704 civil or legal rights, benefits, or privileges guaranteed by
705 law, the Constitution of the State of Florida, or the
706 Constitution of the United States as a resident of a facility.
707 Every resident of a facility shall have the right to:
708 (a) Live in a safe and decent living environment, free from
709 abuse, and neglect, and exploitation.
710 (k) At least 45 days’ notice of relocation or termination
711 of residency from the facility unless, for medical reasons, the
712 resident is certified by a physician to require an emergency
713 relocation to a facility providing a more skilled level of care
714 or the resident engages in a pattern of conduct that is harmful
715 or offensive to other residents. In the case of a resident who
716 has been adjudicated mentally incapacitated, the guardian shall
717 be given at least 45 days’ notice of a nonemergency relocation
718 or residency termination. Reasons for relocation must shall be
719 set forth in writing and provided to the resident or the
720 resident’s legal representative. In order for a facility to
721 terminate the residency of an individual without notice as
722 provided herein, the facility shall show good cause in a court
723 of competent jurisdiction.
724 (3)(a) The agency shall conduct a survey to determine
725 whether the facility is complying with this section general
726 compliance with facility standards and compliance with
727 residents’ rights as a prerequisite to initial licensure or
728 licensure renewal. The agency shall adopt rules for uniform
729 standards and criteria that will be used to determine compliance
730 with facility standards and compliance with residents’ rights.
731 (b) In order to determine whether the facility is
732 adequately protecting residents’ rights, the licensure renewal
733 biennial survey must shall include private informal
734 conversations with a sample of residents and consultation with
735 the ombudsman council in the district in which the facility is
736 located to discuss residents’ experiences within the facility.
737 Section 10. Section 429.41, Florida Statutes, is amended to
738 read:
739 429.41 Rules establishing standards.—
740 (1) It is the intent of the Legislature that rules
741 published and enforced pursuant to this section shall include
742 criteria by which a reasonable and consistent quality of
743 resident care and quality of life may be ensured and the results
744 of such resident care may be demonstrated. Such rules shall also
745 promote ensure a safe and sanitary environment that is
746 residential and noninstitutional in design or nature and may
747 allow for technological advances in the provision of care,
748 safety, and security, including the use of devices, equipment,
749 and other security measures related to wander management,
750 emergency response, staff risk management, and the general
751 safety and security of residents, staff, and the facility. It is
752 further intended that reasonable efforts be made to accommodate
753 the needs and preferences of residents to enhance the quality of
754 life in a facility. Uniform firesafety standards for assisted
755 living facilities shall be established by the State Fire Marshal
756 pursuant to s. 633.206. The agency may adopt rules to administer
757 part II of chapter 408. In order to provide safe and sanitary
758 facilities and the highest quality of resident care
759 accommodating the needs and preferences of residents, The
760 agency, in consultation with the Department of Children and
761 Families and the Department of Health, shall adopt rules,
762 policies, and procedures to administer this part, which must
763 include reasonable and fair minimum standards in relation to:
764 (a) The requirements for and maintenance and the sanitary
765 condition of facilities, not in conflict with, or duplicative
766 of, rules adopted pursuant to s. 381.006(16) and s. 381.0072 and
767 standards established under chapter 553 and s. 633.206, relating
768 to a safe and decent living environment, including furnishings
769 for resident bedrooms or sleeping areas, locking devices, linens
770 plumbing, heating, cooling, lighting, ventilation, living space,
771 and other housing conditions relating to hazards, which will
772 promote ensure the health, safety, and welfare comfort of
773 residents suitable to the size of the structure. The rules must
774 clearly delineate the respective responsibilities of the
775 agency’s licensure and survey staff and the county health
776 departments and ensure that inspections are not duplicative. The
777 agency may collect fees for food service inspections conducted
778 by county health departments and may transfer such fees to the
779 Department of Health.
780 1. Firesafety evacuation capability determination.—An
781 evacuation capability evaluation for initial licensure shall be
782 conducted within 6 months after the date of licensure.
783 2. Firesafety requirements.—
784 a. The National Fire Protection Association, Life Safety
785 Code, NFPA 101 and 101A, current editions, shall be used in
786 determining the uniform firesafety code adopted by the State
787 Fire Marshal for assisted living facilities, pursuant to s.
788 633.206.
789 b. A local government or a utility may charge fees only in
790 an amount not to exceed the actual expenses incurred by the
791 local government or the utility relating to the installation and
792 maintenance of an automatic fire sprinkler system in a licensed
793 assisted living facility structure.
794 c. All licensed facilities must have an annual fire
795 inspection conducted by the local fire marshal or authority
796 having jurisdiction.
797 d. An assisted living facility that is issued a building
798 permit or certificate of occupancy before July 1, 2016, may at
799 its option and after notifying the authority having
800 jurisdiction, remain under the provisions of the 1994 and 1995
801 editions of the National Fire Protection Association, Life
802 Safety Code, NFPA 101, and NFPA 101A. The facility opting to
803 remain under such provisions may make repairs, modernizations,
804 renovations, or additions to, or rehabilitate, the facility in
805 compliance with NFPA 101, 1994 edition, and may utilize the
806 alternative approaches to life safety in compliance with NFPA
807 101A, 1995 edition. However, a facility for which a building
808 permit or certificate of occupancy is issued before July 1,
809 2016, that undergoes Level III building alteration or
810 rehabilitation, as defined in the Florida Building Code, or
811 seeks to utilize features not authorized under the 1994 or 1995
812 editions of the Life Safety Code must thereafter comply with all
813 aspects of the uniform firesafety standards established under s.
814 633.206, and the Florida Fire Prevention Code, in effect for
815 assisted living facilities as adopted by the State Fire Marshal.
816 3. Resident elopement requirements.—Facilities are required
817 to conduct a minimum of two resident elopement prevention and
818 response drills per year. All administrators and direct care
819 staff must participate in the drills, which shall include a
820 review of procedures to address resident elopement. Facilities
821 must document the implementation of the drills and ensure that
822 the drills are conducted in a manner consistent with the
823 facility’s resident elopement policies and procedures.
824 (b) The preparation and annual update of a comprehensive
825 emergency management plan. Such standards must be included in
826 the rules adopted by the agency after consultation with the
827 Division of Emergency Management. At a minimum, the rules must
828 provide for plan components that address emergency evacuation
829 transportation; adequate sheltering arrangements; postdisaster
830 activities, including provision of emergency power, food, and
831 water; postdisaster transportation; supplies; staffing;
832 emergency equipment; individual identification of residents and
833 transfer of records; communication with families; and responses
834 to family inquiries. The comprehensive emergency management plan
835 is subject to review and approval by the county local emergency
836 management agency. During its review, the county local emergency
837 management agency shall ensure that the following agencies, at a
838 minimum, are given the opportunity to review the plan: the
839 Department of Health, the Agency for Health Care Administration,
840 and the Division of Emergency Management. Also, appropriate
841 volunteer organizations must be given the opportunity to review
842 the plan. The county local emergency management agency shall
843 complete its review within 60 days and either approve the plan
844 or advise the facility of necessary revisions. A facility must
845 submit a comprehensive emergency management plan to the county
846 emergency management agency within 30 days after issuance of a
847 license.
848 (c) The number, training, and qualifications of all
849 personnel having responsibility for the care of residents. The
850 rules must require adequate staff to provide for the safety of
851 all residents. Facilities licensed for 17 or more residents are
852 required to maintain an alert staff for 24 hours per day.
853 (d) All sanitary conditions within the facility and its
854 surroundings which will ensure the health and comfort of
855 residents. The rules must clearly delineate the responsibilities
856 of the agency’s licensure and survey staff, the county health
857 departments, and the local authority having jurisdiction over
858 firesafety and ensure that inspections are not duplicative. The
859 agency may collect fees for food service inspections conducted
860 by the county health departments and transfer such fees to the
861 Department of Health.
862 (d)(e) License application and license renewal, transfer of
863 ownership, proper management of resident funds and personal
864 property, surety bonds, resident contracts, refund policies,
865 financial ability to operate, and facility and staff records.
866 (e)(f) Inspections, complaint investigations, moratoriums,
867 classification of deficiencies, levying and enforcement of
868 penalties, and use of income from fees and fines.
869 (f)(g) The enforcement of the resident bill of rights
870 specified in s. 429.28.
871 (g)(h) The care and maintenance of residents provided by
872 the facility, which must include, but is not limited to:
873 1. The supervision of residents;
874 2. The provision of personal services;
875 3. The provision of, or arrangement for, social and leisure
876 activities;
877 4. The assistance in making arrangements arrangement for
878 appointments and transportation to appropriate medical, dental,
879 nursing, or mental health services, as needed by residents;
880 5. The management of medication stored within the facility
881 and as needed by residents;
882 6. The dietary nutritional needs of residents;
883 7. Resident records; and
884 8. Internal risk management and quality assurance.
885 (h)(i) Facilities holding a limited nursing, extended
886 congregate care, or limited mental health license.
887 (i)(j) The establishment of specific criteria to define
888 appropriateness of resident admission and continued residency in
889 a facility holding a standard, limited nursing, extended
890 congregate care, and limited mental health license.
891 (j)(k) The use of physical or chemical restraints. The use
892 of geriatric chairs or Posey restraints is prohibited. Other
893 physical restraints may be used in accordance with agency rules
894 when ordered is limited to half-bed rails as prescribed and
895 documented by the resident’s physician and consented to by with
896 the consent of the resident or, if applicable, the resident’s
897 representative or designee or the resident’s surrogate,
898 guardian, or attorney in fact. Such rules must specify
899 requirements for care planning, staff monitoring, and periodic
900 review by a physician. The use of chemical restraints is limited
901 to prescribed dosages of medications authorized by the
902 resident’s physician and must be consistent with the resident’s
903 diagnosis. Residents who are receiving medications that can
904 serve as chemical restraints must be evaluated by their
905 physician at least annually to assess:
906 1. The continued need for the medication.
907 2. The level of the medication in the resident’s blood.
908 3. The need for adjustments in the prescription.
909 (k)(l) The establishment of specific resident elopement
910 drill requirements, policies, and procedures on resident
911 elopement. Facilities shall conduct a minimum of two resident
912 elopement drills each year. All administrators and direct care
913 staff shall participate in the drills, which must include a
914 review of the facility’s procedures to address resident
915 elopement. Facilities shall document participation in the
916 drills.
917 (2) In adopting any rules pursuant to this part, the agency
918 shall make distinct standards for facilities based upon facility
919 size; the types of care provided; the physical and mental
920 capabilities and needs of residents; the type, frequency, and
921 amount of services and care offered; and the staffing
922 characteristics of the facility. Rules developed pursuant to
923 this section may not restrict the use of shared staffing and
924 shared programming in facilities that are part of retirement
925 communities that provide multiple levels of care and otherwise
926 meet the requirements of law and rule. If a continuing care
927 facility licensed under chapter 651 or a retirement community
928 offering multiple levels of care licenses a building or part of
929 a building designated for independent living for assisted
930 living, staffing requirements established in rule apply only to
931 residents who receive personal, limited nursing, or extended
932 congregate care services under this part. Such facilities shall
933 retain a log listing the names and unit number for residents
934 receiving these services. The log must be available to surveyors
935 upon request. Except for uniform firesafety standards, The
936 agency shall adopt by rule separate and distinct standards for
937 facilities with 16 or fewer beds and for facilities with 17 or
938 more beds. The standards for facilities with 16 or fewer beds
939 must be appropriate for a noninstitutional residential
940 environment; however, the structure may not be more than two
941 stories in height and all persons who cannot exit the facility
942 unassisted in an emergency must reside on the first floor. The
943 agency may make other distinctions among types of facilities as
944 necessary to enforce this part. Where appropriate, the agency
945 shall offer alternate solutions for complying with established
946 standards, based on distinctions made by the agency relative to
947 the physical characteristics of facilities and the types of care
948 offered.
949 (3) Rules adopted by the agency shall encourage the
950 development of homelike facilities that promote the dignity,
951 individuality, personal strengths, and decisionmaking ability of
952 residents.
953 (4) The agency may waive rules adopted under this part to
954 demonstrate and evaluate innovative or cost-effective congregate
955 care alternatives that enable individuals to age in place. Such
956 waivers may be granted only in instances where there is
957 reasonable assurance that the health, safety, or welfare of
958 residents will not be endangered. To apply for a waiver, the
959 licensee shall submit to the agency a written description of the
960 concept to be demonstrated, including goals, objectives, and
961 anticipated benefits; the number and types of residents who will
962 be affected, if applicable; a brief description of how the
963 demonstration will be evaluated; and any other information
964 deemed appropriate by the agency. Any facility granted a waiver
965 shall submit a report of findings to the agency within 12
966 months. At such time, the agency may renew or revoke the waiver
967 or pursue any regulatory or statutory changes necessary to allow
968 other facilities to adopt the same practices. The agency may by
969 rule clarify terms and establish waiver application procedures,
970 criteria for reviewing waiver proposals, and procedures for
971 reporting findings, as necessary to implement this subsection.
972 (5) The agency may use an abbreviated biennial standard
973 licensure inspection that consists of a review of key quality
974 of-care standards in lieu of a full inspection in a facility
975 that has a good record of past performance. However, a full
976 inspection must be conducted in a facility that has a history of
977 class I or class II violations;, uncorrected class III
978 violations; or a class I, class II, or uncorrected class III
979 violation resulting from a complaint referred by the State Long
980 Term Care Ombudsman Program, confirmed ombudsman council
981 complaints, or confirmed licensure complaints within the
982 previous licensure period immediately preceding the inspection
983 or if a potentially serious problem is identified during the
984 abbreviated inspection. The agency shall adopt by rule develop
985 the key quality-of-care standards with input from the State
986 Long-Term Care Ombudsman Council and representatives of provider
987 groups for incorporation into its rules.
988 Section 11. Section 429.435, Florida Statutes, is created
989 to read:
990 429.435 Uniform firesafety standards.—Uniform firesafety
991 standards for assisted living facilities, which are residential
992 board and care occupancies, shall be established by the State
993 Fire Marshal pursuant to s. 633.206.
994 (1) EVACUATION CAPABILITY.—A firesafety evacuation
995 capability determination shall be conducted within 6 months
996 after the date of initial licensure of an assisted living
997 facility, if required.
998 (2) FIRESAFETY REQUIREMENTS.—
999 (a) The National Fire Protection Association, Life Safety
1000 Code, NFPA 101 and 101A, current editions, must be used in
1001 determining the uniform firesafety code adopted by the State
1002 Fire Marshal for assisted living facilities, pursuant to s.
1003 633.206.
1004 (b) A local government or a utility may charge fees that do
1005 not exceed the actual costs incurred by the local government or
1006 the utility for the installation and maintenance of an automatic
1007 fire sprinkler system in a licensed assisted living facility
1008 structure.
1009 (c) All licensed facilities must have an annual fire
1010 inspection conducted by the local fire marshal or authority
1011 having jurisdiction.
1012 (d) An assisted living facility that was issued a building
1013 permit or certificate of occupancy before July 1, 2016, at its
1014 option and after notifying the authority having jurisdiction,
1015 may remain under the provisions of the 1994 and 1995 editions of
1016 the National Fire Protection Association, Life Safety Code, NFPA
1017 101 and 101A. A facility opting to remain under such provisions
1018 may make repairs, modernizations, renovations, or additions to,
1019 or rehabilitate, the facility in compliance with NFPA 101, 1994
1020 edition, and may utilize the alternative approaches to life
1021 safety in compliance with NFPA 101A, 1995 edition. However, a
1022 facility for which a building permit or certificate of occupancy
1023 was issued before July 1, 2016, which undergoes Level III
1024 building alteration or rehabilitation, as defined in the Florida
1025 Building Code, or which seeks to utilize features not authorized
1026 under the 1994 or 1995 editions of the Life Safety Code, shall
1027 thereafter comply with all aspects of the uniform firesafety
1028 standards established under s. 633.206 and the Florida Fire
1029 Prevention Code in effect for assisted living facilities as
1030 adopted by the State Fire Marshal.
1031 Section 12. Section 429.52, Florida Statutes, is amended to
1032 read:
1033 429.52 Staff training and educational requirements
1034 programs; core educational requirement.—
1035 (1) Effective October 1, 2015, Each new assisted living
1036 facility employee who has not previously completed core training
1037 must attend a preservice orientation provided by the facility
1038 before interacting with residents. The preservice orientation
1039 must be at least 2 hours in duration and cover topics that help
1040 the employee provide responsible care and respond to the needs
1041 of facility residents. Upon completion, the employee and the
1042 administrator of the facility must sign a statement that the
1043 employee completed the required preservice orientation. The
1044 facility must keep the signed statement in the employee’s
1045 personnel record.
1046 (2) Administrators and other assisted living facility staff
1047 must meet minimum training and education requirements
1048 established by the agency by rule. This training and education
1049 is intended to assist facilities to appropriately respond to the
1050 needs of residents, to maintain resident care and facility
1051 standards, and to meet licensure requirements.
1052 (3) The agency, in conjunction with providers, shall
1053 develop core training requirements for administrators consisting
1054 of core training learning objectives, a competency test, and a
1055 minimum required score to indicate successful passage completion
1056 of the core competency test training and educational
1057 requirements. The required core competency test training and
1058 education must cover at least the following topics:
1059 (a) State law and rules relating to assisted living
1060 facilities.
1061 (b) Resident rights and identifying and reporting abuse,
1062 neglect, and exploitation.
1063 (c) Special needs of elderly persons, persons with mental
1064 illness, and persons with developmental disabilities and how to
1065 meet those needs.
1066 (d) Nutrition and food service, including acceptable
1067 sanitation practices for preparing, storing, and serving food.
1068 (e) Medication management, recordkeeping, and proper
1069 techniques for assisting residents with self-administered
1070 medication.
1071 (f) Firesafety requirements, including fire evacuation
1072 drill procedures and other emergency procedures.
1073 (g) Care of persons with Alzheimer’s disease and related
1074 disorders.
1075 (4) A new facility administrator must complete the required
1076 core training and education, including the competency test,
1077 within 90 days after the date of employment as an administrator.
1078 Failure to do so is a violation of this part and subjects the
1079 violator to an administrative fine as prescribed in s. 429.19.
1080 Administrators licensed in accordance with part II of chapter
1081 468 are exempt from this requirement. Other licensed
1082 professionals may be exempted, as determined by the agency by
1083 rule.
1084 (5) Administrators are required to participate in
1085 continuing education for a minimum of 12 contact hours every 2
1086 years.
1087 (6) Staff involved with the management of medications and
1088 assisting with the self-administration of medications under s.
1089 429.256 must complete a minimum of 6 additional hours of
1090 training provided by a registered nurse or, a licensed
1091 pharmacist before providing assistance, or agency staff. Two
1092 hours of continuing education are required annually thereafter.
1093 The agency shall establish by rule the minimum requirements of
1094 this additional training.
1095 (7) Other Facility staff shall participate in in-service
1096 training relevant to their job duties as specified by agency
1097 rule of the agency. Topics covered during the preservice
1098 orientation are not required to be repeated during in-service
1099 training. A single certificate of completion that covers all
1100 required in-service training topics may be issued to a
1101 participating staff member if the training is provided in a
1102 single training course.
1103 (8) If the agency determines that there are problems in a
1104 facility which could be reduced through specific staff training
1105 or education beyond that already required under this section,
1106 the agency may require, and provide, or cause to be provided,
1107 the training or education of any personal care staff in the
1108 facility.
1109 (9) The agency shall adopt rules related to these training
1110 and education requirements, the competency test, necessary
1111 procedures, and competency test fees and shall adopt or contract
1112 with another entity to develop and administer the competency
1113 test. The agency shall adopt a curriculum outline with learning
1114 objectives to be used by core trainers, which shall be used as
1115 the minimum core training content requirements. The agency shall
1116 consult with representatives of stakeholder associations and
1117 agencies in the development of the curriculum outline.
1118 (10) The core training required by this section other than
1119 the preservice orientation must be conducted by persons
1120 registered with the agency as having the requisite experience
1121 and credentials to conduct the training. A person seeking to
1122 register as a core trainer must provide the agency with proof of
1123 completion of the minimum core training education requirements,
1124 successful passage of the competency test established under this
1125 section, and proof of compliance with the continuing education
1126 requirement in subsection (5).
1127 (11) A person seeking to register as a core trainer also
1128 must also:
1129 (a) Provide proof of completion of a 4-year degree from an
1130 accredited college or university and must have worked in a
1131 management position in an assisted living facility for 3 years
1132 after being core certified;
1133 (b) Have worked in a management position in an assisted
1134 living facility for 5 years after being core certified and have
1135 1 year of teaching experience as an educator or staff trainer
1136 for persons who work in assisted living facilities or other
1137 long-term care settings;
1138 (c) Have been previously employed as a core trainer for the
1139 agency or department; or
1140 (d) Meet other qualification criteria as defined in rule,
1141 which the agency is authorized to adopt.
1142 (12) The agency shall adopt rules to establish core trainer
1143 registration and removal requirements.
1144 Section 13. This act shall take effect July 1, 2020.