CS/HB 1037

1	A bill to be entitled
2	An act relating to continuing care retirement communities;
3	providing for the provision of continuing care at-home;
4	amending s. 651.011, F.S.; revising definitions; defining
5	"continuing care at-home," "nursing care," "personal
6	services," and "shelter"; amending s. 651.012, F.S.;
7	conforming a cross-reference; amending s. 651.013, F.S.;
8	conforming provisions to changes made by the act; amending
9	s. 651.021, F.S., relating to the requirement for
10	certificates of authority; requiring that a person in the
11	business of issuing continuing care at-home contracts
12	obtain a certificate of authority from the Office of
13	Insurance Regulation; requiring written approval from the
14	Office of Insurance Regulation for a 20 percent or more
15	expansion in the number of continuing care at-home
16	contracts; providing that an actuarial study may be
17	substituted for a feasibility study in specified
18	circumstances; amending s. 651.022, F.S., relating to
19	provisional certificates of authority; conforming
20	provisions to changes made by the act; amending s.
21	651.023, F.S., relating to an application for a
22	certificate of authority; specifying the content of the
23	feasibility study that is included in the application for
24	a certificate; requiring the same minimum reservation
25	requirements for continuing care at-home contracts as
26	continuing care contracts; requiring that a certain amount
27	of the entrance fee collected for contracts resulting from
28	an expansion be placed in an escrow account or on deposit
29	with the department; amending ss. 651.033, 651.035, and
30	651.055, F.S.; requiring a facility to provide proof of
31	compliance with a residency contract; conforming
32	provisions to changes made by the act; creating s.
33	651.057, F.S.; providing additional requirements for
34	continuing care at-home contracts; requiring that a
35	provider who wishes to offer continuing care at-home
36	contracts submit certain additional documents to the
37	office; requiring that the provider comply with certain
38	requirements; limiting the number of continuing care and
39	continuing care at-home contracts at a facility based on
40	the types of units at the facility; amending ss. 651.071,
41	651.091, 651.106, 651.114, 651.118, 651.121, and 651.125,
42	F.S.; conforming provisions to changes made by the act;
43	providing an effective date.
44
45	Be It Enacted by the Legislature of the State of Florida:
46
47	Section 1.  Section 651.011, Florida Statutes, is amended
48	to read:
49	651.011  Definitions.-As used in For the purposes of this
50	chapter, the term:
51	(1)  "Advertising" means the dissemination of written,
52	visual, or electronic information by a provider, or any person
53	affiliated with or controlled by a provider, to potential
54	residents or their representatives for the purpose of inducing
55	such persons to subscribe to or enter into a contract for
56	continuing care or continuing care at-home to reside in a
57	continuing care community that is subject to this chapter.
58	(2)  "Continuing care" or "care" means, pursuant to a
59	contract, furnishing shelter and nursing care or personal
60	services to a resident who resides in a facility as defined in
61	s. 429.02, whether such nursing care or personal services are
62	provided in the facility or in another setting designated in by
63	the contract for continuing care, by to an individual not
64	related by consanguinity or affinity to the resident provider
65	furnishing such care, upon payment of an entrance fee. Other
66	personal services provided must be designated in the continuing
67	care contract. Contracts to provide continuing care include
68	agreements to provide care for any duration, including contracts
69	that are terminable by either party.
70	(3)  "Continuing Care Advisory Council" or "advisory
71	council" means the council established in s. 651.121.
72	(4)  "Continuing care at-home" means, pursuant to a
73	contract other than a contract described in subsection (2),
74	furnishing to a resident who resides outside the facility the
75	right to future access to shelter and nursing care or personal
76	services, whether such services are provided in the facility or
77	in another setting designated in the contract, by an individual
78	not related by consanguinity or affinity to the resident, upon
79	payment of an entrance fee.
80	(5)(4)  "Entrance fee" means an initial or deferred payment
81	of a sum of money or property made as full or partial payment
82	for continuing care or continuing care at-home to assure the
83	resident a place in a facility. An accommodation fee, admission
84	fee, member fee, or other fee of similar form and application
85	are considered to be an entrance fee.
86	(6)(5)  "Facility" means a place where that provides
87	continuing care is furnished and may include one or more
88	physical plants on a primary or contiguous site or an
89	immediately accessible site. As used in this subsection, the
90	term "immediately accessible site" means a parcel of real
91	property separated by a reasonable distance from the facility as
92	measured along public thoroughfares, and the term "primary or
93	contiguous site" means the real property contemplated in the
94	feasibility study required by this chapter.
95	(7)(6)  "Generally accepted accounting principles" means
96	those accounting principles and practices adopted by the
97	Financial Accounting Standards Board and the American Institute
98	of Certified Public Accountants, including Statement of Position
99	90-8 with respect to any full year to which the statement
100	applies.
101	(8)(7)  "Insolvency" means the condition in which the
102	provider is unable to pay its obligations as they come due in
103	the normal course of business.
104	(9)(8)  "Licensed" means that the provider has obtained a
105	certificate of authority from the department.
106	(10)  "Nursing care" means those services or acts rendered
107	to a resident by an individual licensed or certified pursuant to
108	chapter 464.
109	(11)  "Personal services" has the same meaning as in s.
110	429.02.
111	(12)(9)  "Provider" means the owner or operator, whether a
112	natural person, partnership or other unincorporated association,
113	however organized, trust, or corporation, of an institution,
114	building, residence, or other place, whether operated for profit
115	or not, which owner or operator provides continuing care or
116	continuing care at-home for a fixed or variable fee, or for any
117	other remuneration of any type, whether fixed or variable, for
118	the period of care, payable in a lump sum or lump sum and
119	monthly maintenance charges or in installments. The term, but
120	does not apply to mean an entity that has existed and
121	continuously operated a facility located on at least 63 acres in
122	this state providing residential lodging to members and their
123	spouses for at least 66 years on or before July 1, 1989, and has
124	the residential capacity of 500 persons, is directly or
125	indirectly owned or operated by a nationally recognized
126	fraternal organization, is not open to the public, and accepts
127	only its members and their spouses as residents.
128	(13)(10)  "Records" means the permanent financial,
129	directory, and personnel information and data maintained by a
130	provider pursuant to this chapter.
131	(14)(11)  "Resident" means a purchaser of, a nominee of, or
132	a subscriber to a continuing care or continuing care at-home
133	contract agreement. Such contract agreement does not give the
134	resident a part ownership of the facility in which the resident
135	is to reside, unless expressly provided for in the contract
136	agreement.
137	(15)  "Shelter" means an independent living unit, room,
138	apartment, cottage, villa, personal care unit, nursing bed, or
139	other living area within a facility set aside for the exclusive
140	use of one or more identified residents.
141	Section 2.  Section 651.012, Florida Statutes, is amended
142	to read:
143	651.012  Exempted facility; written disclosure of
144	exemption.-Any facility exempted under ss. 632.637(1)(e) and
145	651.011(12)(9) must provide written disclosure of such exemption
146	to each person admitted to the facility after October 1, 1996.
147	This disclosure must be written using language likely to be
148	understood by the person and must briefly explain the exemption.
149	Section 3.  Section 651.013, Florida Statutes, is amended
150	to read:
151	651.013  Chapter exclusive; applicability of other laws.-
152	(1)  Except as herein provided, providers of continuing
153	care and continuing care at-home are shall be governed by the
154	provisions of this chapter and are shall be exempt from all
155	other provisions of the Florida Insurance Code.
156	(2)  In addition to other applicable provisions cited in
157	this chapter, the office has the authority granted under ss.
158	624.302 and 624.303, 624.308-624.312, 624.319(1)-(3), 624.320-
159	624.321, 624.324, and 624.34 of the Florida Insurance Code to
160	regulate providers of continuing care and continuing care at-
161	home.
162	Section 4.  Section 651.021, Florida Statutes, is amended
163	to read:
164	651.021  Certificate of authority required.-
165	(1)  No person may engage in the business of providing
166	continuing care, or issuing contracts for continuing care or
167	continuing care at-home, or constructing agreements or construct
168	a facility for the purpose of providing continuing care in this
169	state without a certificate of authority therefor obtained from
170	the office as provided in this chapter. This subsection does
171	shall not be construed to prohibit the preparation of a the
172	construction site or construction of a model residence unit for
173	marketing purposes, or both. The office may allow the purchase
174	of an existing building for the purpose of providing continuing
175	care if the office determines that the purchase is not being
176	made to circumvent for the purpose of circumventing the
177	prohibitions contained in this section.
178	(2)(a)  Written approval must be obtained from the office
179	before commencing commencement of construction or marketing for
180	an any expansion of a certificated facility equivalent to the
181	addition of at least 20 percent of existing units or 20 percent
182	or more in the number of continuing care at-home contracts,
183	written approval must be obtained from the office. This
184	provision does not apply to construction for which a certificate
185	of need from the Agency for Health Care Administration is
186	required.
187	(a)  For providers that offer both continuing care and
188	continuing care at-home, the 20 percent is based on the total of
189	both existing units and existing contracts for continuing care
190	at-home. For purposes of this subsection, an expansion includes
191	increases in the number of constructed units or continuing care
192	at-home contracts or a combination of both.
193	(b)  The application for such approval shall be on forms
194	adopted by the commission and provided by the office. The
195	application must shall include the feasibility study required by
196	s. 651.022(3) or s. 651.023(1)(b) and such other information as
197	required by s. 651.023. If the expansion is only for continuing
198	care at-home contracts, an actuarial study prepared by an
199	independent actuary in accordance with standards adopted by the
200	American Academy of Actuaries which presents the financial
201	impact of the expansion may be substituted for the feasibility
202	study.
203	(c)  In determining whether an expansion should be
204	approved, the office shall use utilize the criteria provided in
205	ss. 651.022(6) and 651.023(4)(2).
206	Section 5.  Paragraphs (d) and (g) of subsection (2) and
207	subsections (4) and (6) of section 651.022, Florida Statutes,
208	are amended to read:
209	651.022  Provisional certificate of authority;
210	application.-
211	(2)  The application for a provisional certificate of
212	authority shall be on a form prescribed by the commission and
213	shall contain the following information:
214	(d)  The contracts agreements for continuing care and
215	continuing care at-home to be entered into between the provider
216	and residents which meet the minimum requirements of s. 651.055
217	or s. 651.057 and which include a statement describing the
218	procedures required by law relating to the release of escrowed
219	entrance fees. Such statement may be furnished through an
220	addendum.
221	(g)  The forms of the continuing care residency contracts,
222	reservation contracts, escrow agreements, and wait list
223	contracts, if applicable, which are proposed to be used by the
224	provider in the furnishing of care. If The office shall approve
225	finds that the continuing care contracts and escrow agreements
226	that comply with ss. 651.023(1)(c), 651.033, and 651.055, and
227	651.057 it shall approve them. Thereafter, no other form of
228	contract or agreement may be used by the provider until it has
229	been submitted to the office and approved.
230	(4)  If an applicant has or proposes to have more than one
231	facility offering continuing care or continuing care at-home, a
232	separate provisional certificate of authority and a separate
233	certificate of authority must shall be obtained for each
234	facility.
235	(6)  Within 45 days after from the date an application is
236	deemed to be complete, as set forth in paragraph (5)(b), the
237	office shall complete its review and shall issue a provisional
238	certificate of authority to the applicant based upon its review
239	and a determination that the application meets all requirements
240	of law, and that the feasibility study was based on sufficient
241	data and reasonable assumptions, and that the applicant will be
242	able to provide continuing care or continuing care at-home as
243	proposed and meet all financial obligations related to its
244	operations, including the financial requirements of this chapter
245	to provide continuing care as proposed. If the application is
246	denied, the office shall notify the applicant in writing, citing
247	the specific failures to meet the provisions of this chapter.
248	Such denial entitles shall entitle the applicant to a hearing
249	pursuant to the provisions of chapter 120.
250	Section 6.  Section 651.023, Florida Statutes, is amended
251	to read:
252	651.023  Certificate of authority; application.-
253	(1)  After issuance of a provisional certificate of
254	authority, the office shall issue to the holder of such
255	provisional certificate of authority a certificate of authority
256	if; provided, however, that no certificate of authority shall be
257	issued until the holder of the such provisional certificate of
258	authority provides the office with the following information:
259	(a)  Any material change in status with respect to the
260	information required to be filed under s. 651.022(2) in the
261	application for the a provisional certificate of authority.
262	(b)  A feasibility study prepared by an independent
263	consultant which contains all of the information required by s.
264	651.022(3) and contains financial forecasts or projections
265	prepared in accordance with standards adopted promulgated by the
266	American Institute of Certified Public Accountants or financial
267	forecasts or projections prepared in accordance with standards
268	for feasibility studies or continuing care retirement
269	communities adopted promulgated by the Actuarial Standards
270	Board.
271	1.  The study must also contain an independent evaluation
272	and examination opinion, or a comparable opinion acceptable to
273	the office, by the consultant who prepared the study, of the
274	underlying assumptions used as a basis for the forecasts or
275	projections in the study and that the assumptions are reasonable
276	and proper and that the project as proposed is feasible.
277	2.  The study must shall take into account project costs,
278	actual marketing results to date and marketing projections,
279	resident fees and charges, competition, resident contract
280	provisions, and any other factors which affect the feasibility
281	of operating the facility.
282	3.  If the study is prepared by an independent certified
283	public accountant, it must contain an examination opinion for
284	the first 3 years of operations and financial projections having
285	a compilation opinion for the next 3 years. If the study is
286	prepared by an independent consulting actuary, it must contain
287	mortality and morbidity data and an actuary's signed opinion
288	that the project as proposed is feasible and that the study has
289	been prepared in accordance with standards adopted by the
290	American Academy of Actuaries.
291	(c)  Subject to the requirements of subsection (4) (2), a
292	provider may submit an application for a certificate of
293	authority and any required exhibits upon submission of proof
294	that the project has a minimum of 30 percent of the units
295	reserved for which the provider is charging an entrance fee.;
296	however, This does provision shall not apply to an application
297	for a certificate of authority for the acquisition of a facility
298	for which a certificate of authority was issued before prior to
299	October 1, 1983, to a provider who subsequently becomes a debtor
300	in a case under the United States Bankruptcy Code, 11 U.S.C. ss.
301	101 et seq., or to a provider for which the department has been
302	appointed receiver pursuant to the provisions of part II of
303	chapter 631.
304	(d)  Proof that commitments have been secured for both
305	construction financing and long-term financing or a documented
306	plan acceptable to the office has been adopted by the applicant
307	for long-term financing.
308	(e)  Proof that all conditions of the lender have been
309	satisfied to activate the commitment to disburse funds other
310	than the obtaining of the certificate of authority, the
311	completion of construction, or the closing of the purchase of
312	realty or buildings for the facility.
313	(f)  Proof that the aggregate amount of entrance fees
314	received by or pledged to the applicant, plus anticipated
315	proceeds from any long-term financing commitment, plus funds
316	from all other sources in the actual possession of the
317	applicant, equal at least not less than 100 percent of the
318	aggregate cost of constructing or purchasing, equipping, and
319	furnishing the facility plus 100 percent of the anticipated
320	startup losses of the facility.
321	(g)  Complete audited financial statements of the
322	applicant, prepared by an independent certified public
323	accountant in accordance with generally accepted accounting
324	principles, as of the date the applicant commenced business
325	operations or for the fiscal year that ended immediately
326	preceding the date of application, whichever is later, and
327	complete unaudited quarterly financial statements attested to by
328	the applicant after subsequent to the date of the last audit.
329	(h)  Proof that the applicant has complied with the escrow
330	requirements of subsection (5) (3) or subsection (7) (5) and
331	will be able to comply with s. 651.035.
332	(i)  Such other reasonable data, financial statements, and
333	pertinent information as the commission or office may require
334	with respect to the applicant or the facility, to determine the
335	financial status of the facility and the management capabilities
336	of its managers and owners.
337	(2)(j)  Within 30 days after of the receipt of the
338	information required under subsection (1) paragraphs (a)-(h),
339	the office shall examine such information and shall notify the
340	provider in writing, specifically requesting any additional
341	information the office is permitted by law to require. Within 15
342	days after receipt of all of the requested additional
343	information, the office shall notify the provider in writing
344	that all of the requested information has been received and the
345	application is deemed to be complete as of the date of the
346	notice. Failure to so notify the applicant in writing within the
347	15-day period constitutes shall constitute acknowledgment by the
348	office that it has received all requested additional
349	information, and the application shall be deemed to be complete
350	for purposes of review on upon the date of the filing of all of
351	the required additional information.
352	(3)(k)  Within 45 days after an application is deemed
353	complete as set forth in subsection (2) paragraph (j), and upon
354	completion of the remaining requirements of this section, the
355	office shall complete its review and shall issue, or deny a
356	certificate of authority, to the holder of a provisional
357	certificate of authority a certificate of authority. If a
358	certificate of authority is denied, the office must shall notify
359	the holder of the provisional certificate of authority in
360	writing, citing the specific failures to satisfy the provisions
361	of this chapter. If denied, the holder of the provisional
362	certificate is of authority shall be entitled to an
363	administrative hearing pursuant to chapter 120.
364	(4)(2)(a)  The office shall issue a certificate of
365	authority upon determining its determination that the applicant
366	meets all requirements of law and has submitted all of the
367	information required by this section, that all escrow
368	requirements have been satisfied, and that the fees prescribed
369	in s. 651.015(2) have been paid.
370	(a)  Notwithstanding satisfaction of the 30-percent minimum
371	reservation requirement of paragraph (1)(c), no certificate of
372	authority shall be issued until the project has a minimum of 50
373	percent of the units reserved for which the provider is charging
374	an entrance fee, and proof thereof is provided to the office. If
375	a provider offering continuing care at-home is applying for a
376	certificate of authority or approval of an expansion pursuant to
377	s. 651.021(2), the same minimum reservation requirements must be
378	met for the continuing care and continuing care at-home
379	contracts, independently of each other.
380	(b)  In order for a unit to be considered reserved under
381	this section, the provider must collect a minimum deposit of 10
382	percent of the then-current entrance fee for that unit, and must
383	assess a forfeiture penalty of 2 percent of the entrance fee due
384	to termination of the reservation contract after 30 days for any
385	reason other than the death or serious illness of the resident,
386	the failure of the provider to meet its obligations under the
387	reservation contract, or other circumstances beyond the control
388	of the resident that equitably entitle the resident to a refund
389	of the resident's deposit. The reservation contract must shall
390	state the cancellation policy and the terms of the continuing
391	care or continuing care at-home contract to be entered into.
392	(5)(3)  Up to No more than 25 percent of the moneys paid
393	for all or any part of an initial entrance fee may be included
394	or pledged for the construction or purchase of the facility, or
395	included or pledged as security for long-term financing. The
396	term "initial entrance fee" means the total entrance fee charged
397	by the facility to the first occupant of a unit.
398	(a)  A minimum of 75 percent of the moneys paid for all or
399	any part of an initial entrance fee collected for continuing
400	care or continuing care at-home shall be placed in an escrow
401	account or on deposit with the department as prescribed in s.
402	651.033.
403	(b)  For an expansion as provided in s. 651.021(2), a
404	minimum of 75 percent of the moneys paid for all or any part of
405	an initial entrance fee collected for continuing care and 50
406	percent of the moneys paid for all or any part of an initial fee
407	collected for continuing care at-home shall be placed in an
408	escrow account or on deposit with the department as prescribed
409	in s. 651.033.
410	(6)(4)  The provider is shall be entitled to secure release
411	of the moneys held in escrow within 7 days after receipt by the
412	office of an affidavit from the provider, along with appropriate
413	copies to verify, and notification to the escrow agent by
414	certified mail, that the following conditions have been
415	satisfied:
416	(a)  A certificate of occupancy has been issued.
417	(b)  Payment in full has been received for at least no less
418	than 70 percent of the total units of a phase or of the total of
419	the combined phases constructed. If a provider offering
420	continuing care at-home is applying for a release of escrowed
421	entrance fees, the same minimum requirement must be met for the
422	continuing care and continuing care at-home contracts,
423	independently of each other.
424	(c)  The consultant who prepared the feasibility study
425	required by this section or a substitute approved by the office
426	certifies within 12 months before the date of filing for office
427	approval that there has been no material adverse change in
428	status with regard to the feasibility study, with such statement
429	dated not more than 12 months from the date of filing for office
430	approval. If a material adverse change exists should exist at
431	the time of submission, then sufficient information acceptable
432	to the office and the feasibility consultant must shall be
433	submitted which remedies the adverse condition.
434	(d)  Proof that commitments have been secured or a
435	documented plan adopted by the applicant has been approved by
436	the office for long-term financing.
437	(e)  Proof that the provider has sufficient funds to meet
438	the requirements of s. 651.035, which may include funds
439	deposited in the initial entrance fee account.
440	(f)  Proof as to the intended application of the proceeds
441	upon release and proof that the entrance fees when released will
442	be applied as represented to the office.
443
444	Notwithstanding any provision of chapter 120, no person, other
445	than the provider, the escrow agent, and the office, may shall
446	have a substantial interest in any office decision regarding
447	release of escrow funds in any proceedings under chapter 120 or
448	this chapter regarding release of escrow funds.
449	(7)(5)  In lieu of the provider fulfilling the requirements
450	in subsection (5) (3) and paragraphs (6)(4)(b) and (d), the
451	office may authorize the release of escrowed funds to retire all
452	outstanding debts on the facility and equipment upon application
453	of the provider and upon the provider's showing that the
454	provider will grant to the residents a first mortgage on the
455	land, buildings, and equipment that constitute the facility, and
456	that the provider has satisfied satisfies the requirements of
457	paragraphs (6)(4)(a), (c), and (e). Such mortgage shall secure
458	the refund of the entrance fee in the amount required by this
459	chapter. The granting of such mortgage is shall be subject to
460	the following:
461	(a)  The first mortgage is shall be granted to an
462	independent trust that which is beneficially held by the
463	residents. The document creating the trust must include shall
464	contain a provision that it agrees to an annual audit and will
465	furnish to the office all information the office may reasonably
466	require. The mortgage may secure payment on bonds issued to the
467	residents or trustee. Such bonds are shall be redeemable after
468	termination of the residency contract in the amount and manner
469	required by this chapter for the refund of an entrance fee.
470	(b)  Before granting a first mortgage to the residents, all
471	construction must shall be substantially completed and
472	substantially all equipment must shall be purchased. No part of
473	the entrance fees may be pledged as security for a construction
474	loan or otherwise used for construction expenses before the
475	completion of construction.
476	(c)  If the provider is leasing the land or buildings used
477	by the facility, the leasehold interest must shall be for a term
478	of at least 30 years.
479	(8)(6)  The timeframes provided under s. 651.022(5) and (6)
480	apply to applications submitted under s. 651.021(2). The office
481	may not issue a certificate of authority under this chapter to a
482	any facility that which does not have a component that which is
483	to be licensed pursuant to part II of chapter 400 or to part I
484	of chapter 429 or that does which will not offer personal
485	services or nursing services through written contractual
486	agreement. A Any written contractual agreement must be disclosed
487	in the continuing care contract for continuing care or
488	continuing care at-home and is subject to the provisions of s.
489	651.1151, relating to administrative, vendor, and management
490	contracts.
491	(9)(7)  The office may shall not approve an application
492	that which includes in the plan of financing any encumbrance of
493	the operating reserves required by this chapter.
494	Section 7.  Paragraphs (a) and (d) of subsection (3) of
495	section 651.033, Florida Statutes, are amended to read:
496	651.033  Escrow accounts.-
497	(3)  In addition, when entrance fees are required to be
498	deposited in an escrow account pursuant to s. 651.022, s.
499	651.023, or s. 651.055:
500	(a)  The provider shall deliver to the resident a written
501	receipt. The receipt must shall show the payor's name and
502	address, the date, the price of the care contract, and the
503	amount of money paid. A copy of each receipt, together with the
504	funds, shall be deposited with the escrow agent or as provided
505	in paragraph (c). The escrow agent shall release such funds to
506	the provider upon the expiration of 7 days after the date of
507	receipt of the funds by the escrow agent if the provider,
508	operating under a certificate of authority issued by the office,
509	has met the requirements of s. 651.023(6)(4). However, if the
510	resident rescinds the contract within the 7-day period, the
511	escrow agent shall release the escrowed fees to the resident.
512	(d)  A provider may assess a nonrefundable fee, which is
513	separate from the entrance fee, for processing a prospective
514	resident's application for continuing care or continuing care
515	at-home.
516	Section 8.  Subsections (2) and (3) of section 651.035,
517	Florida Statutes, are amended to read:
518	651.035  Minimum liquid reserve requirements.-
519	(2)(a)  In facilities where not all residents are under
520	continuing care or continuing care at-home contracts, the
521	reserve requirements of subsection (1) shall be computed only
522	with respect to the proportional share of operating expenses
523	that which are applicable to residents as defined in s. 651.011.
524	For purposes of this calculation, the proportional share shall
525	be based upon the ratio of residents under continuing care or
526	continuing care at-home contracts to those residents who do not
527	hold such contracts.
528	(b)  In facilities that have voluntarily and permanently
529	discontinued marketing continuing care and continuing care at-
530	home contracts, the office may allow a reduced debt service
531	reserve as required in subsection (1) based upon the ratio of
532	residents under continuing care or continuing care at-home
533	contracts to those residents who do not hold such contracts if
534	the office finds that such reduction is not inconsistent with
535	the security protections intended by this chapter. In making
536	this determination, the office may consider such factors as the
537	financial condition of the facility, the provisions of the
538	outstanding continuing care and continuing care at-home
539	contracts, the ratio of residents under continuing care or
540	continuing care at-home contracts agreements to those residents
541	who do not hold such contracts a continuing care contract, the
542	current occupancy rates, the previous sales and marketing
543	efforts, the life expectancy of the remaining residents contract
544	holders, and the written policies of the board of directors of
545	the provider or a similar board.
546	(3)  If principal and interest payments are paid to a trust
547	that is beneficially held by the residents as described in s.
548	651.023(7)(5), the office may waive all or any portion of the
549	escrow requirements for mortgage principal and interest
550	contained in subsection (1) if the office finds that such waiver
551	is not inconsistent with the security protections intended by
552	this chapter.
553	Section 9.  Section 651.055, Florida Statutes, is amended
554	to read:
555	651.055  Continuing care contracts; right to rescind.-
556	(1)  Each continuing care contract and each addendum to
557	such contract shall be submitted to and approved by the office
558	before prior to its use in this state. Thereafter, no other form
559	of contract shall be used by the provider until unless it has
560	been submitted to and approved by the office. Each contract must
561	shall:
562	(a)  Provide for the continuing care of only one resident,
563	or for two persons occupying space designed for double
564	occupancy, under appropriate regulations established by the
565	provider, and must shall list all properties transferred and
566	their market value at the time of transfer, including donations,
567	subscriptions, fees, and any other amounts paid or payable by,
568	or on behalf of, the resident or residents.
569	(b)  Specify all services that which are to be provided by
570	the provider to each resident, including, in detail, all items
571	that which each resident will receive, whether the items will be
572	provided for a designated time period or for life, and whether
573	the services will be available on the premises or at another
574	specified location. The provider shall indicate which services
575	or items are included in the contract for continuing care and
576	which services or items are made available at or by the facility
577	at extra charge. Such items shall include, but are not limited
578	to, food, shelter, personal services or nursing care, drugs,
579	burial, and incidentals.
580	(c)  Describe the terms and conditions under which a
581	contract for continuing care may be canceled by the provider or
582	by a resident and the conditions, if any, under which all or any
583	portion of the entrance fee will be refunded in the event of
584	cancellation of the contract by the provider or by the resident,
585	including the effect of any change in the health or financial
586	condition of a person between the date of entering a contract
587	for continuing care and the date of initial occupancy of a
588	living unit by that person.
589	(d)  Describe the health and financial conditions required
590	for a person to be accepted as a resident and to continue as a
591	resident, once accepted, including the effect of any change in
592	the health or financial condition of the person between the date
593	of submitting an application for admission to the facility and
594	entering into a continuing care contract. If a prospective
595	resident signs a contract but postpones moving into the
596	facility, the individual is deemed to be occupying a unit at the
597	facility when he or she pays the entrance fee or any portion of
598	the fee, other than a reservation deposit, and begins making
599	monthly maintenance fee payments. Such resident may rescind the
600	contract and receive a full refund of any funds paid, without
601	penalty or forfeiture, within 7 days after executing the
602	contract as specified in subsection (2).
603	(e)  Describe the circumstances under which the resident
604	will be permitted to remain in the facility in the event of
605	financial difficulties of the resident. The stated policy may
606	not be less than the terms stated in s. 651.061.
607	(f)  State the fees that will be charged if the resident
608	marries while at the designated facility, the terms concerning
609	the entry of a spouse to the facility, and the consequences if
610	the spouse does not meet the requirements for entry.
611	(g)  Provide that the contract may be canceled by giving at
612	least 30 days' written notice of cancellation by the provider,
613	the resident, or the person who provided the transfer of
614	property or funds for the care of such resident.; However, if a
615	contract is canceled because there has been a good faith
616	determination that a resident is a danger to himself or herself
617	or others, only such notice as is reasonable under the
618	circumstances is required.
619	1.  The contract must also provide in clear and
620	understandable language, in print no smaller than the largest
621	type used in the body of the contract, the terms governing the
622	refund of any portion of the entrance fee.
623	2.  For a resident whose contract with the facility
624	provides that the resident does not receive a transferable
625	membership or ownership right in the facility, and who has
626	occupied his or her unit, the refund shall be calculated on a
627	pro rata basis with the facility retaining up to 2 percent per
628	month of occupancy by the resident and up to a 5 percent 5-
629	percent processing fee. Such refund must be paid within 120 days
630	after giving the notice of intention to cancel.
631	3.  In addition to a processing fee, if the contract
632	provides for the facility to retain up to 1 percent per month of
633	occupancy by the resident, it may provide that such refund will
634	be paid from the proceeds of the next entrance fees received by
635	the provider for units for which there are no prior claims by
636	any resident until paid in full or, if the provider has
637	discontinued marketing continuing care contracts, within 200
638	days after the date of notice.
639	4.  Unless subsection (5) applies, for any prospective
640	resident, regardless of whether or not such a resident receives
641	a transferable membership or ownership right in the facility,
642	who cancels the contract before occupancy of the unit, the
643	entire amount paid toward the entrance fee shall be refunded,
644	less a processing fee of up to 5 percent of the entire entrance
645	fee; however, the processing fee may not exceed the amount paid
646	by the prospective resident. Such refund must be paid within 60
647	days after giving the notice of intention to cancel. For a
648	resident who has occupied his or her unit and who has received a
649	transferable membership or ownership right in the facility, the
650	foregoing refund provisions do not apply but are deemed
651	satisfied by the acquisition or receipt of a transferable
652	membership or an ownership right in the facility. The provider
653	may not charge any fee for the transfer of membership or sale of
654	an ownership right. A prospective resident, resident, or
655	resident's estate is not entitled to interest of any type on a
656	deposit or entrance fee unless it is specified in the continuing
657	care contract.
658	(h)  State the terms under which a contract is canceled by
659	the death of the resident. These terms may contain a provision
660	that, upon the death of a resident, the entrance fee of such
661	resident is shall be considered earned and becomes shall become
662	the property of the provider. If When the unit is shared, the
663	conditions with respect to the effect of the death or removal of
664	one of the residents must shall be included in the contract.
665	(i)  Describe the policies that which may lead to changes
666	in monthly recurring and nonrecurring charges or fees for goods
667	and services received. The contract must shall provide for
668	advance notice to the resident, of at least not less than 60
669	days, before any change in fees or charges or the scope of care
670	or services is may be effective, except for changes required by
671	state or federal assistance programs.
672	(j)  Provide that charges for care paid in one lump sum may
673	shall not be increased or changed during the duration of the
674	agreed upon care, except for changes required by state or
675	federal assistance programs.
676	(k)  Specify whether or not the facility is, or is
677	affiliated with, a religious, nonprofit, or proprietary
678	organization or management entity; the extent to which the
679	affiliate organization will be responsible for the financial and
680	contractual obligations of the provider; and the provisions of
681	the federal Internal Revenue Code, if any, under which the
682	provider or affiliate is exempt from the payment of federal
683	income tax.
684	(2)  A resident has the right to rescind a continuing care
685	contract and receive a full refund of any funds paid, without
686	penalty or forfeiture, within 7 days after executing the
687	contract. A resident may not be required to move into the
688	facility designated in the contract before the expiration of the
689	7-day period. During the 7-day period, the resident's funds must
690	be held in an escrow account unless otherwise requested by the
691	resident pursuant to s. 651.033(3)(c).
692	(3)  The contract must shall include or shall be
693	accompanied by a statement, printed in boldfaced type, which
694	reads: "This facility and all other continuing care facilities
695	in the State of Florida are regulated by chapter 651, Florida
696	Statutes. A copy of the law is on file in this facility. The law
697	gives you or your legal representative the right to inspect our
698	most recent financial statement and inspection report before
699	signing the contract."
700	(4)  Before the transfer of any money or other property to
701	a provider by or on behalf of a prospective resident, the
702	provider shall present a typewritten or printed copy of the
703	contract to the prospective resident and all other parties to
704	the contract. The provider shall secure a signed, dated
705	statement from each party to the contract certifying that a copy
706	of the contract with the specified attachment, as required
707	pursuant to this chapter, was received.
708	(5)  Except for a resident who postpones moving into the
709	facility but is deemed to have occupied a unit as described in
710	paragraph (1)(d), if a prospective resident dies before
711	occupying the facility or, through illness, injury, or
712	incapacity, is precluded from becoming a resident under the
713	terms of the continuing care contract, the contract is
714	automatically canceled, and the prospective resident or his or
715	her legal representative shall receive a full refund of all
716	moneys paid to the facility, except those costs specifically
717	incurred by the facility at the request of the prospective
718	resident and set forth in writing in a separate addendum, signed
719	by both parties, to the contract.
720	(6)  In order to comply with this section, a provider may
721	furnish information not contained in his or her continuing care
722	contract through an addendum.
723	(7)  Contracts to provide continuing care, including
724	contracts that are terminable by either party, may include
725	agreements to provide care for any duration.
726	(8)(7)  Those contracts entered into after subsequent to
727	July 1, 1977, and before the issuance of a certificate of
728	authority to the provider are valid and binding upon both
729	parties in accordance with their terms. Within 30 days after
730	receipt of a letter from the office notifying the provider of a
731	noncompliant residency contract, the provider shall file a new
732	residency contract for approval that complies with Florida law.
733	Pending review and approval of the new residency contract, the
734	provider may continue to use the previously approved contract.
735	(9)(8)  The provisions of this section shall control over
736	any conflicting provisions contained in part II of chapter 400
737	or in part I of chapter 429.
738	Section 10.  Section 651.057, Florida Statutes, is created
739	to read:
740	651.057  Continuing care at-home contracts.-
741	(1)  In addition to the requirements of s. 651.055, a
742	provider offering contracts for continuing care at-home must:
743	(a)  Disclose the following in the continuing care at-home
744	contract:
745	1.  Whether transportation will be provided to residents
746	when traveling to and from the facility for services;
747	2.  That the provider has no liability for residents
748	residing outside the facility beyond the delivery of services
749	specified in the contract and future access to nursing care or
750	personal services at the facility or in another setting
751	designated in the contract;
752	3.  The mechanism for monitoring residents who live outside
753	the facility;
754	4.  The process that will be followed to establish priority
755	if a resident wishes to exercise his or her right to move into
756	the facility; and
757	5.  The policy that will be followed if a resident living
758	outside the facility relocates to a different residence and no
759	longer avails himself or herself of services provided by the
760	facility.
761	(b)  Ensure that persons employed by or under contract with
762	the provider who assist in the delivery of services to residents
763	residing outside the facility are appropriately licensed or
764	certified as required by law.
765	(c)  Include operating expenses for continuing care at-home
766	contracts in the calculation of the operating reserve required
767	by s. 651.035(1)(c).
768	(d)  Include the operating activities for continuing care
769	at-home contracts in the total operation of the facility when
770	submitting financial reports to the office as required by s.
771	651.026.
772	(2)  A provider that holds a certificate of authority and
773	wishes to offer continuing care at-home must also:
774	(a)  Submit a business plan to the office with the
775	following information:
776	1.  A description of the continuing care at-home services
777	that will be provided, the market to be served, and the fees to
778	be charged;
779	2.  A copy of the proposed continuing care at-home
780	contract;
781	3.  An actuarial study prepared by an independent actuary
782	in accordance with the standards adopted by the American Academy
783	of Actuaries which presents the impact of providing continuing
784	care at-home on the overall operation of the facility; and
785	4.  A market feasibility study that meets the requirements
786	of s. 651.022(3) and documents that there is sufficient interest
787	in continuing care at-home contracts to support such a program;
788	(b)  Demonstrate to the office that the proposal to offer
789	continuing care at-home contracts to individuals who do not
790	immediately move into the facility will not place the provider
791	in an unsound financial condition;
792	(c)  Comply with the requirements of s. 651.021(2), except
793	that an actuarial study may be substituted for the feasibility
794	study; and
795	(d)  Comply with the requirements of this chapter.
796	(3)  Contracts to provide continuing care at-home,
797	including contracts that are terminable by either party, may
798	include agreements to provide care for any duration.
799	(4)  A provider offering continuing care at-home contracts
800	must, at a minimum, have a facility that is licensed under this
801	chapter and has accommodations for independent living which are
802	primarily intended for residents who do not require staff
803	supervision. The facility need not offer assisted living units
804	licensed under part I of chapter 429 or nursing home units
805	licensed under part II of chapter 400 in order to be able to
806	offer continuing care at-home contracts.
807	(a)  The combined number of outstanding continuing care
808	(CCRC) and continuing care at-home (CCAH) contracts allowed at
809	the facility may be the greater of:
810	1.  One and one-half times the combined number of
811	independent living units (ILU), assisted living units (ALF) that
812	are licensed under part I of chapter 429, and nursing home units
813	licensed under part II of chapter 400 at the facility; or
814	2.  Four times the combined number of assisted living units
815	(ALF) that are licensed under part I of chapter 429 and nursing
816	home units that are licensed under part II of chapter 400 at
817	that facility.
818	(b)  The number of independent living units at the facility
819	must be equal to or greater than 10 percent of the initial 100
820	continuing care (CCRC) and continuing care at-home (CCAH)
821	contracts and 5 percent of the combined number of outstanding
822	continuing care (CCRC) and continuing care at-home (CCAH)
823	contracts in excess of 100 issued by that facility.
824	Section 11.  Subsection (1) of section 651.071, Florida
825	Statutes, is amended to read:
826	651.071  Contracts as preferred claims on liquidation or
827	receivership.-
828	(1)  In the event of receivership or liquidation
829	proceedings against a provider, all continuing care and
830	continuing care at-home contracts executed by a provider shall
831	be deemed preferred claims against all assets owned by the
832	provider; however, such claims are shall be subordinate to those
833	priority claims set forth in s. 631.271 and any secured claim as
834	defined in s. 631.011.
835	Section 12.  Paragraph (h) of subsection (2) and subsection
836	(3) of section 651.091, Florida Statutes, are amended to read:
837	651.091  Availability, distribution, and posting of reports
838	and records; requirement of full disclosure.-
839	(2)  Every continuing care facility shall:
840	(h)  Upon request, deliver to the president or chair of the
841	residents' council a copy of any newly approved continuing care
842	or continuing care at-home contract within 30 days after
843	approval by the office.
844	(3)  Before entering into a contract to furnish continuing
845	care or continuing care at-home, the provider undertaking to
846	furnish the care, or the agent of the provider, shall make full
847	disclosure, and provide copies of the disclosure documents to
848	the prospective resident or his or her legal representative, of
849	the following information:
850	(a)  The contract to furnish continuing care or continuing
851	care at-home.
852	(b)  The summary listed in paragraph (2)(b).
853	(c)  All ownership interests and lease agreements,
854	including information specified in s. 651.022(2)(b)8.
855	(d)  In keeping with the intent of this subsection relating
856	to disclosure, the provider shall make available for review,
857	master plans approved by the provider's governing board and any
858	plans for expansion or phased development, to the extent that
859	the availability of such plans do will not put at risk real
860	estate, financing, acquisition, negotiations, or other
861	implementation of operational plans and thus jeopardize the
862	success of negotiations, operations, and development.
863	(e)  Copies of the rules and regulations of the facility
864	and an explanation of the responsibilities of the resident.
865	(f)  The policy of the facility with respect to admission
866	to and discharge from the various levels of health care offered
867	by the facility.
868	(g)  The amount and location of any reserve funds required
869	by this chapter, and the name of the person or entity having a
870	claim to such funds in the event of a bankruptcy, foreclosure,
871	or rehabilitation proceeding.
872	(h)  A copy of s. 651.071.
873	(i)  A copy of the resident's rights as described in s.
874	651.083.
875	Section 13.  Section 651.106, Florida Statutes, is amended
876	to read:
877	651.106  Grounds for discretionary refusal, suspension, or
878	revocation of certificate of authority.-The office, in its
879	discretion, may deny, suspend, or revoke the provisional
880	certificate of authority or the certificate of authority of any
881	applicant or provider if it finds that any one or more of the
882	following grounds applicable to the applicant or provider exist:
883	(1)  Failure by the provider to continue to meet the
884	requirements for the authority originally granted.
885	(2)  Failure by the provider to meet one or more of the
886	qualifications for the authority specified by this chapter.
887	(3)  Material misstatement, misrepresentation, or fraud in
888	obtaining the authority, or in attempting to obtain the same.
889	(4)  Demonstrated lack of fitness or trustworthiness.
890	(5)  Fraudulent or dishonest practices of management in the
891	conduct of business.
892	(6)  Misappropriation, conversion, or withholding of
893	moneys.
894	(7)  Failure to comply with, or violation of, any proper
895	order or rule of the office or commission or violation of any
896	provision of this chapter.
897	(8)  The insolvent condition of the provider or the
898	provider's being in such condition or using such methods and
899	practices in the conduct of its business as to render its
900	further transactions in this state hazardous or injurious to the
901	public.
902	(9)  Refusal by the provider to be examined or to produce
903	its accounts, records, and files for examination, or refusal by
904	any of its officers to give information with respect to its
905	affairs or to perform any other legal obligation under this
906	chapter when required by the office.
907	(10)  Failure by the provider to comply with the
908	requirements of s. 651.026 or s. 651.033.
909	(11)  Failure by the provider to maintain escrow accounts
910	or funds as required by this chapter.
911	(12)  Failure by the provider to meet the requirements of
912	this chapter for disclosure of information to residents
913	concerning the facility, its ownership, its management, its
914	development, or its financial condition or failure to honor its
915	continuing care or continuing care at-home contracts.
916	(13)  Any cause for which issuance of the license could
917	have been refused had it then existed and been known to the
918	office.
919	(14)  Having been found guilty of, or having pleaded guilty
920	or nolo contendere to, a felony in this state or any other
921	state, without regard to whether a judgment or conviction has
922	been entered by the court having jurisdiction of such cases.
923	(15)  In the conduct of business under the license,
924	engaging in unfair methods of competition or in unfair or
925	deceptive acts or practices prohibited under part IX of chapter
926	626.
927	(16)  A pattern of bankrupt enterprises.
928
929	Revocation of a certificate of authority under this section does
930	not relieve a provider from the provider's obligation to
931	residents under the terms and conditions of any continuing care
932	or continuing care at-home contract between the provider and
933	residents or the provisions of this chapter. The provider shall
934	continue to file its annual statement and pay license fees to
935	the office as required under this chapter as if the certificate
936	of authority had continued in full force, but the provider shall
937	not issue any new continuing care contracts. The office may seek
938	an action in the circuit court of Leon County to enforce the
939	office's order and the provisions of this section.
940	Section 14.  Subsection (8) of section 651.114, Florida
941	Statutes, is amended to read:
942	651.114  Delinquency proceedings; remedial rights.-
943	(8)(a)  The rights of the office described in this section
944	are shall be subordinate to the rights of a trustee or lender
945	pursuant to the terms of a resolution, ordinance, loan
946	agreement, indenture of trust, mortgage, lease, security
947	agreement, or other instrument creating or securing bonds or
948	notes issued to finance a facility, and the office, subject to
949	the provisions of paragraph (c), shall not exercise its remedial
950	rights provided under this section and ss. 651.018, 651.106,
951	651.108, and 651.116 with respect to a facility that is subject
952	to a lien, mortgage, lease, or other encumbrance or trust
953	indenture securing bonds or notes issued in connection with the
954	financing of the facility, if the trustee or lender, by
955	inclusion or by amendment to the loan documents or by a separate
956	contract with the office, agrees that the rights of residents
957	under a continuing care or continuing care at-home contract will
958	be honored and will not be disturbed by a foreclosure or
959	conveyance in lieu thereof as long as the resident:
960	1.  Is current in the payment of all monetary obligations
961	required by the continuing care contract;
962	2.  Is in compliance and continues to comply with all
963	provisions of the resident's continuing care contract; and
964	3.  Has asserted no claim inconsistent with the rights of
965	the trustee or lender.
966	(b)  Nothing in This subsection does not require requires a
967	trustee or lender to:
968	1.  Continue to engage in the marketing or resale of new
969	continuing care or continuing care at-home contracts;
970	2.  Pay any rebate of entrance fees as may be required by a
971	resident's continuing care or continuing care at-home contract
972	as of the date of acquisition of the facility by the trustee or
973	lender and until expiration of the period described in paragraph
974	(d);
975	3.  Be responsible for any act or omission of any owner or
976	operator of the facility arising before prior to the acquisition
977	of the facility by the trustee or lender; or
978	4.  Provide services to the residents to the extent that
979	the trustee or lender would be required to advance or expend
980	funds that have not been designated or set aside for such
981	purposes.
982	(c)  Should the office determine, at any time during the
983	suspension of its remedial rights as provided in paragraph (a),
984	that the trustee or lender is not in compliance with the
985	provisions of paragraph (a), or that a lender or trustee has
986	assigned or has agreed to assign all or a portion of a
987	delinquent or defaulted loan to a third party without the
988	office's written consent, the office shall notify the trustee or
989	lender in writing of its determination, setting forth the
990	reasons giving rise to the determination and specifying those
991	remedial rights afforded to the office which the office shall
992	then reinstate.
993	(d)  Upon acquisition of a facility by a trustee or lender
994	and evidence satisfactory to the office that the requirements of
995	paragraph (a) have been met, the office shall issue a 90-day
996	temporary certificate of authority granting the trustee or
997	lender the authority to engage in the business of providing
998	continuing care or continuing care at-home and to issue
999	continuing care or continuing care at-home contracts subject to
1000	the office's right to immediately suspend or revoke the
1001	temporary certificate of authority if the office determines that
1002	any of the grounds described in s. 651.106 apply to the trustee
1003	or lender or that the terms of the contract agreement used as
1004	the basis for the issuance of the temporary certificate of
1005	authority by the office have not been or are not being met by
1006	the trustee or lender since the date of acquisition.
1007	Section 15.  Subsections (4), (7), (9), and (11) of section
1008	651.118, Florida Statutes, are amended to read:
1009	651.118  Agency for Health Care Administration;
1010	certificates of need; sheltered beds; community beds.-
1011	(4)  Not including the residences of residents residing
1012	outside the facility pursuant to a continuing care at-home
1013	contract, the Agency for Health Care Administration shall
1014	approve one sheltered nursing home bed for every four proposed
1015	residential units, including those that are licensed under part
1016	I of chapter 429, in the continuing care facility unless the
1017	provider demonstrates the need for a lesser number of sheltered
1018	nursing home beds based on proposed utilization by prospective
1019	residents or demonstrates the need for additional sheltered
1020	nursing home beds based on actual utilization and demand by
1021	current residents.
1022	(7)  Notwithstanding the provisions of subsection (2), at
1023	the discretion of the continuing care provider, sheltered
1024	nursing home beds may be used for persons who are not residents
1025	of the continuing care facility and who are not parties to a
1026	continuing care contract for a period of up to 5 years after the
1027	date of issuance of the initial nursing home license. A provider
1028	whose 5-year period has expired or is expiring may request an
1029	extension from the Agency for Health Care Administration for an
1030	extension, not to exceed 30 percent of the total sheltered
1031	nursing home beds or 30 sheltered beds, whichever is greater, if
1032	the utilization by residents of the nursing home facility in the
1033	sheltered beds will not generate sufficient income to cover
1034	nursing home facility expenses, as evidenced by one of the
1035	following:
1036	(a)  The nursing home facility has a net loss for the most
1037	recent fiscal year as determined under generally accepted
1038	accounting principles, excluding the effects of extraordinary or
1039	unusual items, as demonstrated in the most recently audited
1040	financial statement.; or
1041	(b)  The nursing home facility would have had a pro forma
1042	loss for the most recent fiscal year, excluding the effects of
1043	extraordinary or unusual items, if revenues were reduced by the
1044	amount of revenues from persons in sheltered beds who were not
1045	residents, as reported on by a certified public accountant.
1046
1047	The Agency for Health Care Administration may shall be
1048	authorized to grant an extension to the provider based on the
1049	evidence required in this subsection. The Agency for Health Care
1050	Administration may request a continuing care facility to use up
1051	to 25 percent of the patient days generated by new admissions of
1052	nonresidents during the extension period to serve Medicaid
1053	recipients for those beds authorized for extended use if there
1054	is a demonstrated need in the respective service area and if
1055	funds are available. A provider who obtains an extension is
1056	prohibited from applying for additional sheltered beds under the
1057	provision of subsection (2), unless additional residential units
1058	are built or the provider can demonstrate need by continuing
1059	care facility residents to the Agency for Health Care
1060	Administration. The 5-year limit does not apply to up to five
1061	sheltered beds designated for inpatient hospice care as part of
1062	a contractual arrangement with a hospice licensed under part IV
1063	of chapter 400. A continuing care facility that uses such beds
1064	after the 5-year period shall report such use to the Agency for
1065	Health Care Administration. For purposes of this subsection,
1066	"resident" means a person who, upon admission to the continuing
1067	care facility, initially resides in a part of the continuing
1068	care facility not licensed under part II of chapter 400, or who
1069	contracts for continuing care at-home.
1070	(9)  This section does not preclude a continuing care
1071	provider from applying to the Agency for Health Care
1072	Administration for a certificate of need for community nursing
1073	home beds or a combination of community and sheltered nursing
1074	home beds. Any nursing home bed located in a continuing care
1075	facility which that is or has been issued for nonrestrictive use
1076	retains shall retain its legal status as a community nursing
1077	home bed unless the provider requests a change in status. Any
1078	nursing home bed located in a continuing care facility and not
1079	issued as a sheltered nursing home bed before prior to 1979 must
1080	be classified as a community bed. The Agency for Health Care
1081	Administration may require continuing care facilities to submit
1082	bed utilization reports for the purpose of determining community
1083	and sheltered nursing home bed inventories based on historical
1084	utilization by residents and nonresidents.
1085	(11)  For a provider issued a provisional certificate of
1086	authority after July 1, 1986, to operate a facility not
1087	previously regulated under this chapter, the following criteria
1088	must shall be met in order to obtain a certificate of need for
1089	sheltered beds pursuant to subsections (2), (3), (4), (5), (6),
1090	and (7):
1091	(a)  Seventy percent or more of the current residents hold
1092	continuing care or continuing care at-home contracts agreements
1093	pursuant to s. 651.011(2) or, if the facility is not occupied,
1094	70 percent or more of the prospective residents will hold such
1095	contracts continuing care agreements pursuant to s. 651.011(2)
1096	as projected in the feasibility study and demonstrated by the
1097	provider's marketing practices; and
1098	(b)  The continuing care or continuing care at-home
1099	contracts agreements entered into or to be entered into by 70
1100	percent or more of the current residents or prospective
1101	residents must pursuant to s. 651.011(2) shall provide nursing
1102	home care for a minimum of 360 cumulative days, and such
1103	residents the holders of the continuing care agreements shall be
1104	charged at rates that which are 80 percent or less than the
1105	rates charged by the provider to persons receiving nursing home
1106	care who have not entered into such contracts continuing care
1107	agreements pursuant to s. 651.011(2).
1108	Section 16.  Subsection (1) of section 651.121, Florida
1109	Statutes, is amended to read:
1110	651.121  Continuing Care Advisory Council.-
1111	(1)  The Continuing Care Advisory Council to the office is
1112	created consisting to consist of 10 members who are residents of
1113	this state appointed by the Governor and geographically
1114	representative of this state. Three members shall be
1115	administrators of facilities that hold valid certificates of
1116	authority under this chapter and shall have been actively
1117	engaged in the offering of continuing care contracts agreements
1118	in this state for 5 years before appointment. The remaining
1119	members include:
1120	(a)  A representative of the business community whose
1121	expertise is in the area of management.
1122	(b)  A representative of the financial community who is not
1123	a facility owner or administrator.
1124	(c)  A certified public accountant.
1125	(d)  An attorney.
1126	(e)  Three residents who hold continuing care or continuing
1127	care at-home contracts agreements with a facility certified in
1128	this state.
1129	Section 17.  Subsection (1) of section 651.125, Florida
1130	Statutes, is amended to read:
1131	651.125  Criminal penalties; injunctive relief.-
1132	(1)  Any person who maintains, enters into, or, as manager
1133	or officer or in any other administrative capacity, assists in
1134	entering into, maintaining, or performing any continuing care or
1135	continuing care at-home contract agreement subject to this
1136	chapter without doing so in pursuance of a valid certificate of
1137	authority or renewal thereof, as contemplated by or provided in
1138	this chapter, or who otherwise violates any provision of this
1139	chapter or rule adopted in pursuance of this chapter, commits is
1140	guilty of a felony of the third degree, punishable as provided
1141	in s. 775.082 or s. 775.083. Each violation of this chapter
1142	constitutes a separate offense.
1143	Section 18.  This act shall take effect July 1, 2011.

CODING: Words stricken are deletions; words underlined are additions.