Senate Bill sb0884
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
By Senator Rich
34-755A-07
1 A bill to be entitled
2 An act relating to hospitals; providing
3 legislative findings; providing definitions;
4 providing that information concerning nursing
5 care for patients be made available to the
6 public; providing for staffing schedules and
7 patterns; providing criteria for staffing
8 schedules of nursing personnel and a daily
9 census for patient-care units; requiring each
10 hospital to make staffing levels and schedules
11 available to the public for a certain period of
12 time; requiring that records be made available
13 to the public upon request; requiring hospitals
14 to provide quarterly reports; requiring
15 hospitals to provide the Agency for Health Care
16 Administration with certain information
17 regarding nursing personnel; requiring the
18 agency to make certain information regarding
19 hospital staff and operations available to the
20 public on its Internet website and upon
21 request; providing criteria governing the
22 provision of such information; providing rights
23 for hospital employees; authorizing the agency
24 to inspect and audit certain books and records
25 of a hospital; providing a penalty for a
26 hospital's refusal to file a report, timely
27 file a report, file a false report, file an
28 incomplete report, or produce certain requested
29 documents or records to the agency; authorizing
30 the agency to grant an extension of a deadline
31
1
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
34-755A-07
1 for a hospital to file a report; providing an
2 appropriation; providing an effective date.
3
4 Be It Enacted by the Legislature of the State of Florida:
5
6 Section 1. (1) SHORT TITLE.--This section may be
7 cited as the "Patients' Right-to-Know Act."
8 (2) LEGISLATIVE FINDINGS.--The Legislature finds that
9 consumers in this state have a right to obtain access to
10 information concerning the quality and safety of the health
11 care provided in hospitals in this state in order to make
12 better decisions about their choice of health care provider.
13 (3) DEFINITIONS.--As used in this section, the term:
14 (a) "Agency" means Agency for Health Care
15 Administration.
16 (b) "Average daily census" means the average number of
17 inpatients receiving services in any given 24-hour period,
18 beginning at midnight, in each clinical service area of the
19 hospital.
20 (c) "Agency nurse" means any direct-care nurse who is
21 not directly employed by the hospital, who provides care in
22 the hospital, and who is working for purposes of providing
23 supplemental staffing in a hospital.
24 (d) "Direct-care nurse" means any registered nurse who
25 has direct responsibility to oversee or carry out medical
26 regimens or nursing care for one or more patients. A nurse
27 administrator, nurse supervisor, nurse educator, charge nurse,
28 or other registered nurse who does not have a specific patient
29 assignment may not be included in calculating the staffing
30 level.
31
2
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
34-755A-07
1 (e) "Hospital" means an acute care hospital that is
2 licensed under s. 395.003, Florida Statutes.
3 (f) "Nurse" means a registered nurse.
4 (g) "Nursing care" means care that falls within the
5 scope of practice set forth in chapter 464, Florida Statutes,
6 and other laws and rules or care that is otherwise encompassed
7 within recognized professional standards of nursing practice,
8 including assessment, nursing diagnosis, planning,
9 intervention, evaluation, and patient advocacy.
10 (h) "Retaliate" means to discipline, discharge,
11 suspend, demote, harass, deny employment or promotion, lay
12 off, or take any other adverse action against a direct-care
13 nurse as a result of that nurse taking any action described in
14 this section.
15 (i) "Staffing level" means the actual numerical
16 registered nurse-to-patient ratio within a nursing department
17 or unit.
18 (j) "Unit" means a functional division or area of a
19 hospital in which nursing care is provided.
20 (4) PUBLIC AVAILABILITY OF STAFFING LEVELS AND
21 SCHEDULES.--
22 (a) The number of registered professional nurses,
23 licensed practical nurses, and other nursing personnel
24 assigned to each patient-care unit shall be consistent with
25 the types of nursing care needed by the patients and the
26 capabilities of the staff. Patients on each unit shall be
27 evaluated near the end of each change of shift by criteria
28 developed by the hospital. There shall be staffing schedules
29 reflecting the actual nursing personnel required for the
30 hospital and for each patient unit. Staffing patterns must
31
3
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
34-755A-07
1 reflect consideration of nursing goals, standards of nursing
2 practice, and the needs of the patients.
3 (b) The current staffing level and anticipated
4 staffing schedule shall be available upon request for each
5 patient-care unit for the effective date of that schedule.
6 Each schedule must list the assigned nursing personnel and the
7 average daily census for each patient-care unit. The hospital
8 shall retain and make available to the public the historic
9 staffing level and schedules for the prior 5 years.
10 (c) All records required under this section, including
11 anticipated staffing schedules and the methods to determine
12 and adjust staffing levels, shall be made available to the
13 public upon request.
14 (d) All records required under this section shall be
15 maintained by the facility for at least 5 years.
16 (5) HOSPITAL REPORTS.--Each hospital shall prepare a
17 quarterly report that includes the average daily staffing
18 levels by unit, the percentage of nursing hours that are
19 completed by agency nurses by unit, the number and description
20 of OSHA violations, the nurse vacancy rate, the nurse turnover
21 rate, and the number and description of complaints made to the
22 Joint Commission on Accreditation of Healthcare Organizations
23 or to the agency.
24 (6) HOSPITAL DATA.--
25 (a) Each hospital shall submit to the agency, in a
26 format designated by the agency and in accordance with the
27 timetable specified by the agency, a statistical profile of
28 registered nurses and other nurses employed by the hospital in
29 patient care, including the nurse-vacancy rate and
30 nurse-turnover rate. The agency shall make each hospital's
31 statistical profile available on its website by July 1, 2008,
4
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
34-755A-07
1 and in hard-copy format upon request. The agency shall update
2 the data made available pursuant to this paragraph annually.
3 (b) Using available data or data voluntarily submitted
4 by hospitals and used as indicators by the Joint Commission on
5 Accreditation of Healthcare Organizations, the agency shall
6 make available for each hospital, on its website by October 1,
7 2008, and in a hard-copy format upon request, the average
8 daily staffing levels by unit; the percentage of nursing hours
9 that are completed by contract or agency nurses by unit,
10 number, and a description of OSHA violations; and the number
11 and a description of complaints. The website must also list
12 each hospital's system affiliations if the hospital is
13 affiliated with a nonprofit, for-profit, or public health care
14 system or corporation. The agency shall update the data made
15 available pursuant to this paragraph annually.
16 (c) The agency shall use available national standards
17 when designating the reporting format for the statistical
18 profile required by paragraph (a) and when making available
19 the average daily staffing levels by unit as required by
20 paragraph (b). The agency shall consult with the Comprehensive
21 Health Information System Advisory Council regarding the
22 reporting format. The agency shall calculate and make
23 available the average daily staffing levels by unit in a
24 manner that health care research has shown to have a
25 significant effect on the quality of patient care and patient
26 outcomes.
27 (d) The agency shall ensure that the nurse staffing
28 data made available pursuant to paragraph (b) is risk-adjusted
29 for patient acuity using the risk-adjustment methodology
30 described in s. 408.061(1)(a), Florida Statutes, or an
31 equivalent methodology consistent with national standards
5
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
34-755A-07
1 employed by the Agency for Healthcare Research and Quality.
2 The agency shall consult with the Comprehensive Health
3 Information System Advisory Council regarding the methodology
4 for risk-adjusting the patient acuity used to comply with this
5 paragraph.
6 (7) EMPLOYEE RIGHTS.--
7 (a) A hospital may not penalize, discriminate against,
8 or retaliate in any manner against a direct-care nurse for
9 refusing an assignment that would violate requirements set
10 forth in this section.
11 (b) A hospital may not penalize, discriminate against,
12 or retaliate in any manner against an employee with respect to
13 compensation for, or terms, conditions, or privileges of,
14 employment if such an employee in good faith, individually or
15 in conjunction with another persons or persons:
16 1. Reports a violation or suspected violation of this
17 section to a regulatory agency, a private accreditation body,
18 or management personnel of the hospital;
19 2. Initiates, cooperates in, or otherwise participates
20 in an investigation or proceeding brought by a regulatory
21 agency or private accreditation body concerning matters
22 covered by this section;
23 3. Informs or discusses violations or suspected
24 violations of this section with other employees, with any
25 representative of the employees, with a patient or patient
26 representative, or with the public; or
27 4. Otherwise avails himself or herself of the rights
28 set forth in this section.
29
30 For purposes of this paragraph, an employee is acting in good
31 faith if the employee reasonably believes that the information
6
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
34-755A-07
1 reported or disclosed is true and that a violation has
2 occurred or may occur.
3 (8) IMPLEMENTATION AND ENFORCEMENT.--
4 (a) In order to ensure compliance with this section,
5 the agency may inspect and audit books and records of
6 individual or corporate hospitals, including books and records
7 of related organizations with which a health care provider or
8 a hospital has had transactions. Upon presentation of a
9 written request for inspection to a health care provider or a
10 hospital by the agency or its staff, the health care provider
11 or the hospital shall make available to the agency or its
12 staff for inspection, copying, and review all books and
13 records relevant to the determination of whether the health
14 care provider or the hospital has complied with this section.
15 (b) Any hospital that refuses to file a report, fails
16 to timely file a report, files a false report, or files an
17 incomplete report and, upon notification, fails to timely file
18 a complete report required under this section or a rule
19 adopted thereunder, or that fails to provide documents or
20 records requested by the agency under this section, shall be
21 punished by a fine not exceeding $1,000 per day for each day
22 in violation, to be imposed and collected by the agency.
23 Pursuant to rules adopted by the agency, the agency may, upon
24 a showing of good cause, grant a one-time extension of any
25 deadline for a hospital to timely file a report as required by
26 this section.
27 Section 2. The sum of $250,000 is appropriated from
28 the General Revenue Fund to the Agency for Health Care
29 Administration for the purpose of administering the provisions
30 of this act requiring the agency to collect, from hospitals or
31 other sources, information regarding the staffing or operation
7
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2007 SB 884
34-755A-07
1 of hospitals and to make such information available on its
2 website or upon request.
3 Section 3. This act shall take effect upon becoming a
4 law.
5
6 *****************************************
7 SENATE SUMMARY
8 Requires that information concerning nursing care for
patients be made available to the public. Provides
9 staffing schedules and patterns. Provides criteria for
staffing schedules for nursing personnel and a daily
10 census for patient-care units. Requires each hospital to
make staffing levels and schedules available to the
11 public for a certain period of time. Provides that
records are available to the public upon request.
12 Requires hospitals to provide the Agency for Health Care
Administration with certain information regarding nursing
13 personnel. Requires the agency to make certain
information regarding hospital staff and operations
14 available to the public on its Internet website and upon
request. Provides criteria governing the provision of
15 such information. Provides rights for hospital employees.
Authorizes the agency to inspect and audit certain books
16 and records of a hospital. Provides a penalty for a
hospital's refusal to file a report, timely file a
17 report, file a false report, file an incomplete report,
or produce certain requested documents or records to the
18 agency. Authorizes the agency to grant an extension of a
deadline for a hospital to file a report. Provides an
19 appropriation.
20
21
22
23
24
25
26
27
28
29
30
31
8
CODING: Words stricken are deletions; words underlined are additions.