Florida Senate - 2011 CS for SB 1458
By the Committee on Health Regulation; and Senator Garcia
588-03820A-11 20111458c1
1 A bill to be entitled
2 An act relating to assisted care communities; amending
3 s. 400.141, F.S.; deleting adult care communities from
4 the standards and rules of the Agency for Health Care
5 Administration which apply to registered pharmacists
6 under contract with a nursing home and related health
7 care facilities; amending s. 408.820, F.S.; providing
8 that assisted living facilities are exempt from
9 certain provisions authorizing the agency to impose
10 administrative fines for violations of laws and
11 applicable rules; amending s. 409.912, F.S.; requiring
12 the agency to provide for the establishment of a
13 demonstration project for a psychiatric facility in
14 Miami-Dade County; amending s. 429.01, F.S.; revising
15 legislative intent and the purposes of the Assisted
16 Living Facilities Act; amending s. 429.02, F.S.;
17 providing, revising, and deleting definitions;
18 amending s. 429.04, F.S.; deleting provisions
19 exempting a home health agency from licensure as an
20 assisted living facility under certain circumstances;
21 amending s. 429.07, F.S.; deleting limited nursing
22 services as a category of care in which the agency may
23 issue a license; revising the criteria and
24 requirements for categories of care in which the
25 agency may issue a license; revising the licensing
26 fees; requiring the agency to conduct a survey to
27 determine whether a facility must be monitored;
28 providing that certain cited assisted living
29 facilities are subject to unannounced monitoring
30 activities; providing for a registered nurse to
31 participate in monitoring visits within a certain time
32 following a class I or class II violation involving
33 nursing care; amending s. 429.08, F.S.; requiring
34 emergency medical technicians or paramedics to report
35 the operations of an unlicensed assisted living
36 facility; amending s. 429.11, F.S.; requiring the
37 Agency for Health Care Administration to develop an
38 abbreviated form for submission of proof of financial
39 ability to operate an assisted living facility;
40 amending s. 429.12, F.S.; deleting the provision that
41 requires a transferor of an assisted living facility
42 to advise the transferee that a plan of correction
43 must be submitted by the transferee and approved by
44 the agency within a specified period; amending s.
45 429.14, F.S.; deleting a provision that authorizes the
46 agency to impose an administrative penalty due to the
47 actions of a facility’s employee; revising the actions
48 for which the agency may impose an administrative
49 penalty; conforming a provision to changes made by the
50 act; deleting the provision that authorizes the agency
51 to revoke or deny the license of an assisted living
52 facility that has certain class I violations; deleting
53 a provisions that requires the agency to provide to
54 the Division of Hotels and Restaurants of the
55 Department of Business and Professional Regulation a
56 monthly list of assisted living facilities that have
57 had their licenses denied, suspended, or revoked;
58 amending s. 429.17, F.S.; conforming provisions to
59 changes made by the act; revising requirements for a
60 conditional license; amending s. 429.178, F.S.;
61 providing safety requirements for facilities serving
62 persons with Alzheimer’s disease or other related
63 disorders; deleting a provision relating to a
64 facility’s responsibility for the payment of certain
65 training and education programs; amending s. 429.19,
66 F.S.; revising procedures for the Agency for Health
67 Care Administration regarding the imposition of fines
68 for violations of ch. 429, F.S., related to adult care
69 communities; specifying the conditions or occurrences
70 that constitute a class I, class II, class III, or
71 class IV violation; amending s. 429.195, F.S.;
72 prohibiting the licensee of an assisted living
73 facility from contracting or promising to pay or
74 receive any commission, bonus, kickback, or rebate or
75 from engaging in any split-fee arrangement with any
76 health care provider or health care facility;
77 providing certain exceptions; amending s. 429.20,
78 F.S.; prohibiting the solicitation of contributions of
79 any kind in a threatening, coercive, or unduly
80 forceful manner by or on behalf of an assisted living
81 facility; deleting provisions specifying that the
82 solicitation or receipt of contributions is grounds
83 for denial, suspension, or revocation of a license for
84 an assisted living facility; amending s. 429.23, F.S.;
85 revising reporting requirements with respect to
86 adverse incidents; amending s. 429.255, F.S.;
87 permitting certain licensed persons to provide limited
88 nursing services; deleting the provision that allows
89 volunteers to perform duties within the scope of their
90 license or certification in facilities that are
91 licensed to provide extended congregate care; amending
92 s. 429.256, F.S.; authorizing a facility to require
93 certain dispensing systems for residents’
94 prescriptions; revising criteria for assistance with
95 self-administration of medication; amending s. 429.26,
96 F.S.; removing a requirement that a facility notify a
97 licensed physician when a resident exhibits certain
98 signs of dementia, cognitive impairment, or change of
99 condition; amending s. 429.27, F.S.; revising
100 provisions relating to the property and personal
101 effects of residents of a facility; requiring a
102 facility’s licensee, owner, administrator, staff, or
103 representative to execute a surety bond for each
104 resident for whom power of attorney has been granted
105 to the licensee, owner, administrator, or staff;
106 deleting the provision that requires a governmental
107 agency or private charitable agency to receive a
108 statement of all funds and other property of a
109 resident; deleting a provision that prohibits an
110 administrator of a facility from levying an additional
111 charge to the individual or the account for any
112 supplies or services that the facility has agreed by
113 contract to provide; repealing s. 429.275(4), F.S.,
114 relating to rulemaking authority of the Department of
115 Elderly Affairs over financial records, personnel
116 procedures, accounting procedures, reporting
117 procedures, and insurance coverage for residents of
118 assisted living facilities; amending s. 429.28, F.S.,
119 relating to the resident bill of rights; revising the
120 number of days’ notice for relocation or termination
121 of residency at a facility; removing responsibilities
122 of the agency for conducting compliance surveys and
123 complaint investigations; revising the actions of a
124 person for which a staff member or employee of a
125 facility is prohibited from taking retaliatory action
126 upon; prohibiting the administrator of a facility from
127 terminating the residency of an individual under
128 certain circumstances; amending s. 429.41, F.S.;
129 revising rulemaking authority regarding resident care
130 and maintenance of facilities; requiring the State
131 Fire Marshal, in cooperation with the agency, to
132 establish and enforce firesafety standards; deleting
133 the requirement for a facility to conduct a minimum
134 number of resident elopement drills; requiring the
135 agency to use an abbreviated biennial standard
136 licensure inspection; requiring the agency, in
137 consultation with the Department of Health, to
138 develop, maintain, and update the key quality-of-care
139 standards with input from the State Long-Term Care
140 Ombudsman Council and representatives of associations
141 and organizations representing assisted living
142 facilities; amending s. 429.42, F.S.; removing a
143 provision that required a corrective plan for
144 deficiencies related to assistance with the self
145 administration of medication or the administration of
146 medication; deleting a requirement that the agency
147 employ a certain number of pharmacists among its
148 personnel who inspect assisted living facilities;
149 amending s. 429.445, F.S.; removing a requirement that
150 an assisted living facility submit certain information
151 to the agency before commencing construction to expand
152 the facility; amending s. 429.47, F.S.; authorizing an
153 owner of an assisted living facility to advertise to
154 the public while the facility is under construction or
155 is seeking licensure; deleting a provision that
156 prohibits a freestanding facility from advertising or
157 implying that any part of it is a nursing home;
158 amending s. 429.49, F.S.; conforming terminology to
159 changes made by the act; amending s. 429.52, F.S.;
160 revising training and education requirements for
161 certain administrators, facility staff, and other
162 licensed professionals; requiring training providers
163 certified by the department to meet continuing
164 education requirements and standards; providing
165 conditions for the sanctioning of training providers
166 and trainees; amending s. 429.53, F.S.; removing
167 provisions relating to preconstruction approvals and
168 reviews and agency consultations; repealing s. 429.54,
169 F.S., relating to the collection of information
170 regarding the actual cost of providing services in
171 assisted living facilities and local subsidies;
172 amending s. 429.71, F.S.; clarifying terminology;
173 removing a provision authorizing the agency to request
174 a plan to remedy violations by adult family-care
175 homes; conforming terminology to changes made by the
176 act; amending s. 429.81, F.S.; specifying that
177 residency agreements require a resident to provide 30
178 days’ written notice of intent to terminate his or her
179 residency; creating s. 430.081, F.S.; authorizing the
180 Department of Elderly Affairs to sanction training
181 providers and trainees for infractions involving any
182 required training; providing training infractions;
183 providing sanctions; amending s. 817.505, F.S.;
184 providing that payments by an assisted living facility
185 are not considered patient brokering under certain
186 circumstances; providing that licensure fees adjusted
187 by consumer price index increases prior to the
188 effective date of the act are not intended to be reset
189 by the act and may continue to accrue as authorized by
190 law; providing an effective date.
191
192 Be It Enacted by the Legislature of the State of Florida:
193
194 Section 1. Paragraph (d) of subsection (1) of section
195 400.141, Florida Statutes, is amended to read:
196 400.141 Administration and management of nursing home
197 facilities.—
198 (1) Every licensed facility shall comply with all
199 applicable standards and rules of the agency and shall:
200 (d) Provide for resident use of a community pharmacy as
201 specified in s. 400.022(1)(q). Any other law to the contrary
202 notwithstanding, a registered pharmacist licensed in Florida,
203 that is under contract with a facility licensed under this
204 chapter or chapter 429, shall repackage a nursing facility
205 resident’s bulk prescription medication which has been packaged
206 by another pharmacist licensed in any state in the United States
207 into a unit dose system compatible with the system used by the
208 nursing facility, if the pharmacist is requested to offer such
209 service. In order to be eligible for the repackaging, a resident
210 or the resident’s spouse must receive prescription medication
211 benefits provided through a former employer as part of his or
212 her retirement benefits, a qualified pension plan as specified
213 in s. 4972 of the Internal Revenue Code, a federal retirement
214 program as specified under 5 C.F.R. s. 831, or a long-term care
215 policy as defined in s. 627.9404(1). A pharmacist who correctly
216 repackages and relabels the medication and the nursing facility
217 which correctly administers such repackaged medication under
218 this paragraph may not be held liable in any civil or
219 administrative action arising from the repackaging. In order to
220 be eligible for the repackaging, a nursing facility resident for
221 whom the medication is to be repackaged shall sign an informed
222 consent form provided by the facility which includes an
223 explanation of the repackaging process and which notifies the
224 resident of the immunities from liability provided in this
225 paragraph. A pharmacist who repackages and relabels prescription
226 medications, as authorized under this paragraph, may charge a
227 reasonable fee for costs resulting from the administration
228 implementation of this provision.
229 Section 2. Subsection (13) of section 408.820, Florida
230 Statutes, is amended to read:
231 408.820 Exemptions.—Except as prescribed in authorizing
232 statutes, the following exemptions shall apply to specified
233 requirements of this part:
234 (13) Assisted living facilities, as provided under part I
235 of chapter 429, are exempt from ss. s. 408.810(10) and
236 408.813(2).
237 Section 3. Subsection (41) of section 409.912, Florida
238 Statutes, is amended to read:
239 409.912 Cost-effective purchasing of health care.—The
240 agency shall purchase goods and services for Medicaid recipients
241 in the most cost-effective manner consistent with the delivery
242 of quality medical care. To ensure that medical services are
243 effectively utilized, the agency may, in any case, require a
244 confirmation or second physician’s opinion of the correct
245 diagnosis for purposes of authorizing future services under the
246 Medicaid program. This section does not restrict access to
247 emergency services or poststabilization care services as defined
248 in 42 C.F.R. part 438.114. Such confirmation or second opinion
249 shall be rendered in a manner approved by the agency. The agency
250 shall maximize the use of prepaid per capita and prepaid
251 aggregate fixed-sum basis services when appropriate and other
252 alternative service delivery and reimbursement methodologies,
253 including competitive bidding pursuant to s. 287.057, designed
254 to facilitate the cost-effective purchase of a case-managed
255 continuum of care. The agency shall also require providers to
256 minimize the exposure of recipients to the need for acute
257 inpatient, custodial, and other institutional care and the
258 inappropriate or unnecessary use of high-cost services. The
259 agency shall contract with a vendor to monitor and evaluate the
260 clinical practice patterns of providers in order to identify
261 trends that are outside the normal practice patterns of a
262 provider’s professional peers or the national guidelines of a
263 provider’s professional association. The vendor must be able to
264 provide information and counseling to a provider whose practice
265 patterns are outside the norms, in consultation with the agency,
266 to improve patient care and reduce inappropriate utilization.
267 The agency may mandate prior authorization, drug therapy
268 management, or disease management participation for certain
269 populations of Medicaid beneficiaries, certain drug classes, or
270 particular drugs to prevent fraud, abuse, overuse, and possible
271 dangerous drug interactions. The Pharmaceutical and Therapeutics
272 Committee shall make recommendations to the agency on drugs for
273 which prior authorization is required. The agency shall inform
274 the Pharmaceutical and Therapeutics Committee of its decisions
275 regarding drugs subject to prior authorization. The agency is
276 authorized to limit the entities it contracts with or enrolls as
277 Medicaid providers by developing a provider network through
278 provider credentialing. The agency may competitively bid single
279 source-provider contracts if procurement of goods or services
280 results in demonstrated cost savings to the state without
281 limiting access to care. The agency may limit its network based
282 on the assessment of beneficiary access to care, provider
283 availability, provider quality standards, time and distance
284 standards for access to care, the cultural competence of the
285 provider network, demographic characteristics of Medicaid
286 beneficiaries, practice and provider-to-beneficiary standards,
287 appointment wait times, beneficiary use of services, provider
288 turnover, provider profiling, provider licensure history,
289 previous program integrity investigations and findings, peer
290 review, provider Medicaid policy and billing compliance records,
291 clinical and medical record audits, and other factors. Providers
292 shall not be entitled to enrollment in the Medicaid provider
293 network. The agency shall determine instances in which allowing
294 Medicaid beneficiaries to purchase durable medical equipment and
295 other goods is less expensive to the Medicaid program than long
296 term rental of the equipment or goods. The agency may establish
297 rules to facilitate purchases in lieu of long-term rentals in
298 order to protect against fraud and abuse in the Medicaid program
299 as defined in s. 409.913. The agency may seek federal waivers
300 necessary to administer these policies.
301 (41) The agency shall establish provide for the development
302 of a demonstration project by establishment in Miami-Dade County
303 of a long-term-care facility and a psychiatric facility licensed
304 pursuant to chapter 395 to improve access to health care for a
305 predominantly minority, medically underserved, and medically
306 complex population and to evaluate alternatives to nursing home
307 care and general acute care for such population. Such project is
308 to be located in a health care condominium and collocated
309 colocated with licensed facilities providing a continuum of
310 care. These projects are The establishment of this project is
311 not subject to the provisions of s. 408.036 or s. 408.039.
312 Section 4. Subsection (2) of section 429.01, Florida
313 Statutes, is amended to read:
314 429.01 Short title; purpose.—
315 (2) The purpose of this act is to:
316 (a) Promote the availability of appropriate services for
317 elderly persons and adults with disabilities in the least
318 restrictive and most homelike environment;, to
319 (b) Encourage the development of facilities that promote
320 the dignity, individuality, privacy, and decisionmaking ability
321 of such persons;, to
322 (c) Provide for the health, safety, and welfare of
323 residents of assisted living facilities in the state;, to
324 (d) Promote continued improvement of such facilities;, to
325 encourage the development of innovative and affordable
326 facilities particularly for persons with low to moderate
327 incomes;, to
328 (e) Ensure that all agencies of the state cooperate in the
329 protection of such residents;, and to
330 (f) Ensure that needed economic, social, mental health,
331 health, and leisure services are made available to residents of
332 such facilities through the efforts of the Agency for Health
333 Care Administration, the Department of Elderly Affairs, the
334 Department of Children and Family Services, the Department of
335 Health, assisted living facilities, and other community
336 agencies.
337
338 To the maximum extent possible, appropriate community-based
339 programs must be available to state-supported residents to
340 augment the services provided in assisted living facilities. The
341 Legislature recognizes that assisted living facilities are an
342 important part of the continuum of long-term care in the state
343 as community-based social models that have a health component
344 and not as medical or nursing facilities. In support of the goal
345 of aging in place, the Legislature further recognizes that
346 assisted living facilities should be operated and regulated as
347 residential environments with supportive services and not as
348 medical or nursing facilities and, as such, should not be
349 subject to the same regulations as medical or nursing facilities
350 but instead be regulated in a less restrictive manner that is
351 appropriate for a residential, nonmedical setting. The services
352 available in these facilities, either directly or through
353 contract or agreement, are intended to help residents remain as
354 independent as possible. Regulations governing these facilities
355 must be sufficiently flexible to allow facilities to adopt
356 policies that enable residents to age in place when resources
357 are available to meet their needs and accommodate their
358 preferences.
359 Section 5. Section 429.02, Florida Statutes, is amended to
360 read:
361 429.02 Definitions.—When used in this part, the term:
362 (1) “Activities of daily living” means functions and tasks
363 for self-care, including ambulation, bathing, dressing, eating,
364 grooming, and toileting, and other similar tasks.
365 (2) “Administrator” means an individual at least 21 years
366 of age who is responsible for the operation and maintenance of
367 an assisted living facility; for promoting the resident’s
368 dignity, autonomy, independence, and privacy in the least
369 restrictive and most homelike setting consistent with the
370 resident’s preferences and physical and mental statuses; and for
371 ensuring the appropriateness of continued placement of a
372 resident, in consultation with the resident, resident’s
373 representative or designee, if applicable, and the resident’s
374 physician.
375 (3) “Agency” means the Agency for Health Care
376 Administration.
377 (4) “Aging in place” or “age in place” means the process of
378 providing increased or adjusted services to a person to
379 compensate for the physical or mental decline that may occur
380 with the aging process, in order to maximize the person’s
381 dignity and independence and permit them to remain in a
382 familiar, noninstitutional, residential environment for as long
383 as possible, as determined by the individual, his or her
384 physician, and the administrator. Such services may be provided
385 by facility staff, volunteers, family, or friends, or through
386 contractual arrangements with a third party.
387 (5) “Arbitration” means a process whereby a neutral third
388 person or panel, called an arbitrator or arbitration panel,
389 considers the facts and arguments presented by the parties and
390 renders a decision that may be biding or nonbinding as provided
391 for in chapter 44.
392 (6)(5) “Assisted living facility” means any residential
393 setting that provides, directly or indirectly by means of
394 contracts or arrangements, for a period exceeding 24 hours,
395 building or buildings, section or distinct part of a building,
396 private home, boarding home, home for the aged, or other
397 residential facility, whether operated for profit or not, which
398 undertakes through its ownership or management to provide
399 housing, meals, and one or more personal services that meet the
400 resident’s changing needs and preferences for a period exceeding
401 24 hours to one or more adults who are not relatives of the
402 owner or administrator. As used in this subsection, the term
403 “residential setting” includes, but is not limited to, a
404 building or buildings, section or distinct part of a building,
405 private home, or other residence.
406 (7)(6) “Chemical restraint” means a pharmacologic drug that
407 physically limits, restricts, or deprives an individual of
408 movement or mobility, and is used for discipline or convenience
409 and not required for the treatment of medical symptoms.
410 (8)(7) “Community living support plan” means a written
411 document prepared by a mental health resident and the resident’s
412 mental health case manager, in consultation with the
413 administrator or the administrator’s designee, of an assisted
414 living facility with a limited mental health license or the
415 administrator’s designee. A copy must be provided to the
416 administrator. The plan must include information about the
417 supports, services, and special needs of the resident which
418 enable the resident to live in the assisted living facility and
419 a method by which facility staff can recognize and respond to
420 the signs and symptoms particular to that resident which
421 indicate the need for professional services.
422 (9)(8) “Cooperative agreement” means a written statement of
423 understanding between a mental health care provider and the
424 administrator of the assisted living facility with a limited
425 mental health license in which a mental health resident is
426 living. The agreement must specify directions for accessing
427 emergency and after-hours care for the mental health resident. A
428 single cooperative agreement may service all mental health
429 residents who are clients of the same mental health care
430 provider.
431 (10)(9) “Department” means the Department of Elderly
432 Affairs.
433 (11)(10) “Emergency” means a situation, physical condition,
434 or method of operation which presents imminent danger of death
435 or serious physical or mental harm to facility residents.
436 (12)(11) “Extended congregate care” means acts beyond those
437 authorized in subsection (19) (16) that may be performed
438 pursuant to part I of chapter 464 by persons licensed thereunder
439 while carrying out their professional duties, and other
440 supportive services which may be specified by rule. The purpose
441 of such services is to enable residents to age in place in a
442 residential environment despite mental or physical limitations
443 that might otherwise disqualify them from residency in a
444 facility licensed under this part.
445 (13)(12) “Guardian” means a person to whom the law has
446 entrusted the custody and control of the person or property, or
447 both, of a person who has been legally adjudged incapacitated.
448 (14) “Licensed facility” means an assisted living facility
449 for which a licensee has been issued a license pursuant to this
450 part and part II of chapter 408.
451 (15)(13) “Limited nursing services” means acts that may be
452 performed pursuant to part I of chapter 464 by persons licensed
453 thereunder while carrying out their professional duties but
454 limited to those acts which the department specifies by rule.
455 Acts which may be specified by rule as allowable limited nursing
456 services shall be for persons who meet the admission criteria
457 established by the department for assisted living facilities and
458 shall not be complex enough to require 24-hour nursing
459 supervision and may include such services as the application and
460 care of routine dressings, and care of casts, braces, and
461 splints.
462 (16)(14) “Managed risk” means the process by which the
463 facility staff discuss the service plan and the needs of the
464 resident with the resident and, if applicable, the resident’s
465 representative or designee or the resident’s surrogate,
466 guardian, or attorney in fact, in such a way that the
467 consequences of a decision, including any inherent risk, are
468 explained to all parties and reviewed periodically in
469 conjunction with the service plan, taking into account changes
470 in the resident’s status and the ability of the facility to
471 respond accordingly.
472 (17)(15) “Mental health resident” means an individual who
473 receives social security disability income due to a mental
474 disorder as determined by the Social Security Administration or
475 receives supplemental security income due to a mental disorder
476 as determined by the Social Security Administration and receives
477 optional state supplementation.
478 (18) “Person” means any individual, partnership,
479 corporation, association, or governmental unit.
480 (19)(16) “Personal services” means direct physical
481 assistance with or supervision of the activities of daily living
482 and the self-administration of medication and other similar
483 services which the department may define by rule. “Personal
484 services” shall not be construed to mean the provision of
485 medical, nursing, dental, or mental health services.
486 (20)(17) “Physical restraint” means a device which
487 physically limits, restricts, or deprives an individual of
488 movement or mobility, including, but not limited to, a half-bed
489 rail, a full-bed rail, a geriatric chair, and a posey restraint.
490 The term “physical restraint” shall also include any device
491 which was not specifically manufactured as a restraint but which
492 has been altered, arranged, or otherwise used for this purpose.
493 The term shall not include bandage material used for the purpose
494 of binding a wound or injury.
495 (21)(18) “Relative” means an individual who is the father,
496 mother, stepfather, stepmother, son, daughter, brother, sister,
497 grandmother, grandfather, great-grandmother, great-grandfather,
498 grandson, granddaughter, uncle, aunt, first cousin, nephew,
499 niece, husband, wife, father-in-law, mother-in-law, son-in-law,
500 daughter-in-law, brother-in-law, sister-in-law, stepson,
501 stepdaughter, stepbrother, stepsister, half brother, or half
502 sister of an owner or administrator.
503 (22)(19) “Resident” means a person 18 years of age or
504 older, residing in and receiving care from an assisted living a
505 facility.
506 (23)(20) “Resident’s representative or designee” means a
507 person other than the owner, or an agent or employee of the
508 assisted living facility, designated in writing by the resident,
509 if legally competent, to receive notice of changes in the
510 contract executed pursuant to s. 429.24; to receive notice of
511 and to participate in meetings between the resident and the
512 facility owner, administrator, or staff concerning the rights of
513 the resident; to assist the resident in contacting the ombudsman
514 council if the resident has a complaint against the facility; or
515 to bring legal action on behalf of the resident pursuant to s.
516 429.29.
517 (24)(21) “Service plan” means a written plan, developed and
518 agreed upon by the resident and, if applicable, the resident’s
519 representative or designee or the resident’s surrogate,
520 guardian, or attorney in fact, if any, and the administrator or
521 the administrator’s designee representing the facility, which
522 addresses the unique physical and psychosocial needs, abilities,
523 and personal preferences of each resident receiving extended
524 congregate care services. The plan shall include a brief written
525 description, in easily understood language, of what services
526 shall be provided, who shall provide the services, when the
527 services shall be rendered, and the purposes and benefits of the
528 services.
529 (25)(22) “Shared responsibility” means exploring the
530 options available to a resident within a facility and the risks
531 involved with each option when making decisions pertaining to
532 the resident’s abilities, preferences, and service needs,
533 thereby enabling the resident and, if applicable, the resident’s
534 representative or designee, or the resident’s surrogate,
535 guardian, or attorney in fact, and the facility to develop a
536 service plan which best meets the resident’s needs and seeks to
537 improve the resident’s quality of life.
538 (26)(23) “Supervision” means reminding residents to engage
539 in activities of daily living and the self-administration of
540 medication, and, when necessary, observing or providing verbal
541 cuing to residents while they perform these activities. The term
542 “supervision” does not include one-on-one observation.
543 (27)(24) “Supplemental security income,” Title XVI of the
544 Social Security Act, means a program through which the Federal
545 Government guarantees a minimum monthly income to every person
546 who is age 65 or older, or disabled, or blind and meets the
547 income and asset requirements.
548 (28)(25) “Supportive services” means services designed to
549 encourage and assist residents aged persons or adults with
550 disabilities to remain in the least restrictive living
551 environment and to maintain their independence as long as
552 possible.
553 (29)(26) “Twenty-four-hour nursing supervision” means
554 services that are ordered by a physician for a resident whose
555 condition requires the supervision of a physician and continued
556 monitoring of vital signs and physical status. Such services
557 shall be: medically complex enough to require constant
558 supervision, assessment, planning, or intervention by a nurse;
559 required to be performed by or under the direct supervision of
560 licensed nursing personnel or other professional personnel for
561 safe and effective performance; required on a daily basis; and
562 consistent with the nature and severity of the resident’s
563 condition or the disease state or stage.
564 Section 6. Paragraphs (g) and (h) of subsection (2) of
565 section 429.04, Florida Statutes, are amended to read:
566 429.04 Facilities to be licensed; exemptions.—
567 (2) The following are exempt from licensure under this
568 part:
569 (g) Any facility certified under chapter 651, or a
570 retirement community, may provide services authorized under this
571 part or part III of chapter 400 to its residents who live in
572 single-family homes, duplexes, quadruplexes, or apartments
573 located on the campus without obtaining a license to operate an
574 assisted living facility if residential units within such
575 buildings are used by residents who do not require staff
576 supervision for that portion of the day when personal services
577 are not being delivered and the owner obtains a home health
578 license to provide such services. However, any building or
579 distinct part of a building on the campus that is designated for
580 persons who receive personal services and require supervision
581 beyond that which is available while such services are being
582 rendered must be licensed in accordance with this part. If a
583 facility provides personal services to residents who do not
584 otherwise require supervision and the owner is not licensed as a
585 home health agency, the buildings or distinct parts of buildings
586 where such services are rendered must be licensed under this
587 part. A resident of a facility that obtains a home health
588 license may contract with a home health agency of his or her
589 choice, provided that the home health agency provides liability
590 insurance and workers’ compensation coverage for its employees.
591 Facilities covered by this exemption may establish policies that
592 give residents the option of contracting for services and care
593 beyond that which is provided by the facility to enable them to
594 age in place. For purposes of this section, a retirement
595 community consists of a facility licensed under this part or a
596 facility licensed under part II of chapter 400, and apartments
597 designed for independent living located on the same campus.
598 (h) Any residential unit for independent living which is
599 located within a facility certified under chapter 651, or any
600 residential unit for independent living which is collocated
601 colocated with a nursing home licensed under part II of chapter
602 400 or collocated colocated with a facility licensed under this
603 part in which services are provided through an outpatient clinic
604 or a nursing home on an outpatient basis.
605 Section 7. Subsections (3) and (4) of section 429.07,
606 Florida Statutes, are amended, and subsections (6) and (7) are
607 added to that section, to read:
608 429.07 License required; fee.—
609 (3) In addition to the requirements of s. 408.806, each
610 license granted by the agency must state the type of care for
611 which the license is granted. Licenses shall be issued for one
612 or more of the following categories of care: standard, extended
613 congregate care, limited nursing services, or limited mental
614 health.
615 (a) A standard license shall be issued to a licensee for a
616 facility facilities providing one or more of the personal
617 services identified in s. 429.02. Such facilities may also
618 employ or contract with a person licensed under part I of
619 chapter 464 to administer medications and perform other tasks as
620 specified in s. 429.255.
621 (b) An extended congregate care license shall be issued to
622 a licensee for a facility facilities providing, directly or
623 through contract, services beyond those authorized in paragraph
624 (a), including services performed by persons licensed under part
625 I of chapter 464 and supportive services, as defined by rule, to
626 persons who would otherwise be disqualified from continued
627 residence in a facility licensed under this part.
628 1. In order for extended congregate care services to be
629 provided, the agency must first determine that all requirements
630 established in law and rule are met and must specifically
631 designate, on the facility’s license, that such services may be
632 provided and whether the designation applies to all or part of
633 the facility. Such designation may be made at the time of
634 initial licensure or relicensure, or upon request in writing by
635 a licensee under this part and part II of chapter 408. The
636 notification of approval or the denial of the request shall be
637 made in accordance with part II of chapter 408. Existing
638 facilities qualifying to provide extended congregate care
639 services must have maintained a standard license and may not
640 have been subject to administrative sanctions during the
641 previous 2 years, or since initial licensure if the facility has
642 been licensed for less than 2 years, for any of the following
643 reasons:
644 a. A class I or class II violation;
645 b. Three or more repeat or recurring class III violations
646 of identical or similar resident care standards from which a
647 pattern of noncompliance is found by the agency;
648 c. Three or more class III violations that were not
649 corrected in accordance with the corrective action plan approved
650 by the agency;
651 b.d. Violation of resident care standards which results in
652 requiring the facility to employ the services of a consultant
653 pharmacist or consultant dietitian; or
654 e. Denial, suspension, or revocation of a license for
655 another facility licensed under this part in which the applicant
656 for an extended congregate care license has at least 25 percent
657 ownership interest; or
658 c.f. Imposition of a moratorium pursuant to this part or
659 part II of chapter 408 or initiation of injunctive proceedings.
660 2. A licensee facility that is licensed to provide extended
661 congregate care services shall maintain a written progress
662 report for on each person who receives services, and the report
663 must describe which describes the type, amount, duration, scope,
664 and outcome of services that are rendered and the general status
665 of the resident’s health. A registered nurse, or appropriate
666 designee, representing the agency shall visit the facility at
667 least quarterly to monitor residents who are receiving extended
668 congregate care services and to determine if the facility is in
669 compliance with this part, part II of chapter 408, and relevant
670 rules. One of the visits may be in conjunction with the regular
671 survey. The monitoring visits may be provided through
672 contractual arrangements with appropriate community agencies. A
673 registered nurse shall serve as part of the team that inspects
674 the facility. The agency may waive one of the required yearly
675 monitoring visits for a facility that has been licensed for at
676 least 24 months to provide extended congregate care services,
677 if, during the inspection, the registered nurse determines that
678 extended congregate care services are being provided
679 appropriately, and if the facility has no class I or class II
680 violations and no uncorrected class III violations. The agency
681 must first consult with the long-term care ombudsman council for
682 the area in which the facility is located to determine if any
683 complaints have been made and substantiated about the quality of
684 services or care. The agency may not waive one of the required
685 yearly monitoring visits if complaints have been made and
686 substantiated.
687 3. A licensee facility that is licensed to provide extended
688 congregate care services shall must:
689 a. Demonstrate the capability to meet unanticipated
690 resident service needs.
691 b. Offer a physical environment that promotes a homelike
692 setting, provides for resident privacy, promotes resident
693 independence, and allows sufficient congregate space as defined
694 by rule.
695 c. Have sufficient staff available, taking into account the
696 physical plant and firesafety features of the residential
697 setting building, to assist with the evacuation of residents in
698 an emergency.
699 d. Adopt and follow policies and procedures that maximize
700 resident independence, dignity, choice, and decisionmaking to
701 permit residents to age in place, so that moves due to changes
702 in functional status are minimized or avoided.
703 e. Allow residents or, if applicable, a resident’s
704 representative, designee, surrogate, guardian, or attorney in
705 fact to make a variety of personal choices, participate in
706 developing service plans, and share responsibility in
707 decisionmaking.
708 f. Implement the concept of managed risk.
709 g. Provide, directly or through contract, the services of a
710 person licensed under part I of chapter 464.
711 h. In addition to the training mandated in s. 429.52,
712 provide specialized training as defined by rule for facility
713 staff.
714 4. A facility that is licensed to provide extended
715 congregate care services is exempt from the criteria for
716 continued residency set forth in rules adopted under s. 429.41.
717 A licensed facility must adopt its own requirements within
718 guidelines for continued residency set forth by rule. However,
719 the facility may not serve residents who require 24-hour nursing
720 supervision. A licensed facility that provides extended
721 congregate care services must also provide each resident with a
722 written copy of facility policies governing admission and
723 retention.
724 5. The primary purpose of extended congregate care services
725 is to allow residents, as they become more impaired, the option
726 of remaining in a familiar setting from which they would
727 otherwise be disqualified for continued residency. A facility
728 licensed to provide extended congregate care services may also
729 admit an individual who exceeds the admission criteria for a
730 facility with a standard license, if the individual is
731 determined appropriate for admission to the extended congregate
732 care facility.
733 6. Before the admission of an individual to a facility
734 licensed to provide extended congregate care services, the
735 individual must undergo a medical examination as provided in s.
736 429.26(4) and the licensee facility must develop a preliminary
737 service plan for the individual.
738 7. When a licensee facility can no longer provide or
739 arrange for services in accordance with the resident’s service
740 plan and needs and the licensee’s facility’s policy, the
741 licensee facility shall make arrangements for relocating the
742 person in accordance with s. 429.28(1)(k).
743 8. Failure to provide extended congregate care services may
744 result in denial of extended congregate care license renewal.
745 (c) A limited nursing services license shall be issued to a
746 facility that provides services beyond those authorized in
747 paragraph (a) and as specified in this paragraph.
748 1. In order for limited nursing services to be provided in
749 a facility licensed under this part, the agency must first
750 determine that all requirements established in law and rule are
751 met and must specifically designate, on the facility’s license,
752 that such services may be provided. Such designation may be made
753 at the time of initial licensure or relicensure, or upon request
754 in writing by a licensee under this part and part II of chapter
755 408. Notification of approval or denial of such request shall be
756 made in accordance with part II of chapter 408. Existing
757 facilities qualifying to provide limited nursing services shall
758 have maintained a standard license and may not have been subject
759 to administrative sanctions that affect the health, safety, and
760 welfare of residents for the previous 2 years or since initial
761 licensure if the facility has been licensed for less than 2
762 years.
763 2. Facilities that are licensed to provide limited nursing
764 services shall maintain a written progress report on each person
765 who receives such nursing services, which report describes the
766 type, amount, duration, scope, and outcome of services that are
767 rendered and the general status of the resident’s health. A
768 registered nurse representing the agency shall visit such
769 facilities at least twice a year to monitor residents who are
770 receiving limited nursing services and to determine if the
771 facility is in compliance with applicable provisions of this
772 part, part II of chapter 408, and related rules. The monitoring
773 visits may be provided through contractual arrangements with
774 appropriate community agencies. A registered nurse shall also
775 serve as part of the team that inspects such facility.
776 3. A person who receives limited nursing services under
777 this part must meet the admission criteria established by the
778 agency for assisted living facilities. When a resident no longer
779 meets the admission criteria for a facility licensed under this
780 part, arrangements for relocating the person shall be made in
781 accordance with s. 429.28(1)(k), unless the facility is licensed
782 to provide extended congregate care services.
783 (4) In accordance with s. 408.805, an applicant or licensee
784 shall pay a fee for each license application submitted under
785 this part, part II of chapter 408, and applicable rules. The
786 amount of the fee shall be established by rule.
787 (a) The biennial license fee required of a facility is $300
788 per license, with an additional fee of $71 $50 per resident
789 based on the total licensed resident capacity of the facility,
790 except that no additional fee will be assessed for beds used by
791 designated for recipients of Medicaid home and community-based
792 waiver programs optional state supplementation payments provided
793 for in s. 409.212. The total fee may not exceed $13,443 $10,000.
794 (b) In addition to the total fee assessed under paragraph
795 (a), the agency shall require facilities that are licensed to
796 provide extended congregate care services under this part to pay
797 an additional fee per licensed facility. The amount of the
798 biennial fee shall be $400 per license, with an additional fee
799 of $10 per resident based on the total licensed resident
800 capacity of the facility.
801 (c) In addition to the total fee assessed under paragraph
802 (a), the agency shall require facilities that are licensed to
803 provide limited nursing services under this part to pay an
804 additional fee per licensed facility. The amount of the biennial
805 fee shall be $250 per license, with an additional fee of $10 per
806 resident based on the total licensed resident capacity of the
807 facility.
808 (6) In order to determine whether the facility is
809 adequately protecting residents’ rights as provided in s.
810 429.28, the agency’s standard license survey shall include
811 private informal conversations with a sample of residents and
812 consultation with the ombudsman council in the planning and
813 service area in which the facility is located to discuss
814 residents’ experiences within the facility.
815 (7) An assisted living facility that has been cited within
816 the previous 24-month period for a class I violation or class II
817 violation, regardless of the status of any enforcement or
818 disciplinary action, is subject to periodic unannounced
819 monitoring to determine if the facility is in compliance with
820 this part, part II of chapter 408, and applicable rules.
821 Monitoring may occur through a desk review or an onsite
822 assessment. If the class I violation or class II violation
823 relates to providing or failing to provide nursing care, a
824 registered nurse must participate in the monitoring visits
825 during the 12-month period following the violation.
826 Section 8. Paragraph (a) of subsection (2) of section
827 429.08, Florida Statutes, is amended to read:
828 429.08 Unlicensed facilities; referral of person for
829 residency to unlicensed facility; penalties.—
830 (2) It is unlawful to knowingly refer a person for
831 residency to an unlicensed assisted living facility; to an
832 assisted living facility the license of which is under denial or
833 has been suspended or revoked; or to an assisted living facility
834 that has a moratorium pursuant to part II of chapter 408.
835 (a) Any health care practitioner, as defined in s. 456.001,
836 or emergency medical technician or paramedic certified under
837 part III of chapter 401, who is aware of the operation of an
838 unlicensed facility shall report that facility to the agency.
839 Failure to report a facility that the practitioner knows or has
840 reasonable cause to suspect is unlicensed shall be reported to
841 the practitioner’s licensing board.
842 Section 9. Subsection (8) is added to section 429.11,
843 Florida Statutes, to read:
844 429.11 Initial application for license; provisional
845 license.—
846 (8) The agency shall develop an abbreviated form for
847 submission of proof of financial ability to operate under s.
848 408.810(8) which is specific to applicants for a license to
849 operate an assisted living facility. The form must request
850 information that demonstrates the applicant has adequate
851 resources to sustain operations and has sufficient assets,
852 credit, and projected revenues to cover liabilities and expenses
853 of the facility based on the number of beds and services the
854 applicant will provide.
855 Section 10. Section 429.12, Florida Statutes, is amended to
856 read:
857 429.12 Sale or transfer of ownership of a facility.—It is
858 the intent of the Legislature to protect the rights of the
859 residents of an assisted living facility when the facility is
860 sold or the ownership thereof is transferred. Therefore, In
861 addition to the requirements of part II of chapter 408, whenever
862 a facility is sold or the ownership thereof is transferred,
863 including leasing,:
864 (1) the transferee shall notify the residents, in writing,
865 of the change of ownership within 7 days after receipt of the
866 new license in order to protect the rights of the residents of
867 an assisted living facility.
868 (2) The transferor of a facility the license of which is
869 denied pending an administrative hearing shall, as a part of the
870 written change-of-ownership contract, advise the transferee that
871 a plan of correction must be submitted by the transferee and
872 approved by the agency at least 7 days before the change of
873 ownership and that failure to correct the condition which
874 resulted in the moratorium pursuant to part II of chapter 408 or
875 denial of licensure is grounds for denial of the transferee’s
876 license.
877 Section 11. Section 429.14, Florida Statutes, is amended to
878 read:
879 429.14 Administrative penalties.—
880 (1) In addition to the requirements of part II of chapter
881 408, the agency may deny, revoke, and suspend any license issued
882 under this part and impose an administrative fine in the manner
883 provided in chapter 120 against a licensee for a violation of
884 any provision of this part, part II of chapter 408, or
885 applicable rules, or for any of the following actions by a
886 licensee, or for the actions of any person subject to level 2
887 background screening under s. 408.809, or for the actions of any
888 facility employee:
889 (a) An intentional or negligent act seriously affecting the
890 health, safety, or welfare of a resident of the facility.
891 (b) The determination by the agency that the owner lacks
892 the financial ability to provide continuing adequate care to
893 residents.
894 (c) Misappropriation or conversion of the property of a
895 resident of the facility.
896 (d) Failure to follow the criteria and procedures provided
897 under part I of chapter 394 relating to the transportation,
898 voluntary admission, and involuntary examination of a facility
899 resident.
900 (d)(e) A citation of any of the following violations
901 deficiencies as specified in s. 429.19:
902 1. One or more cited class I violations deficiencies.
903 2. Three or more cited class II violations deficiencies.
904 3. Five or more cited class III violations deficiencies
905 that have been cited on a single survey and have not been
906 corrected within the times specified.
907 (e)(f) Failure to comply with the background screening
908 standards of this part, s. 408.809(1), or chapter 435.
909 (f)(g) Violation of a moratorium.
910 (g)(h) Failure of the license applicant, the licensee
911 during relicensure, or a licensee that holds a provisional
912 license to meet the minimum license requirements of this part,
913 or related rules, at the time of license application or renewal.
914 (h)(i) An intentional or negligent life-threatening act in
915 violation of the uniform firesafety standards for assisted
916 living facilities or other firesafety standards that threatens
917 the health, safety, or welfare of a resident of a facility, as
918 communicated to the agency by the local authority having
919 jurisdiction or the State Fire Marshal.
920 (i)(j) Knowingly operating any unlicensed facility or
921 providing without a license any service that must be licensed
922 under this chapter or chapter 400.
923 (j)(k) Any act constituting a ground upon which application
924 for a license may be denied.
925 (2) Upon notification by the local authority having
926 jurisdiction or by the State Fire Marshal, the agency may deny
927 or revoke the license of a licensee of an assisted living
928 facility that fails to correct cited fire code violations that
929 affect or threaten the health, safety, or welfare of a resident
930 of a facility.
931 (3) The agency may deny a license to any applicant or
932 controlling interest as defined in part II of chapter 408 which
933 has or had a 25-percent or greater financial or ownership
934 interest in any other facility licensed under this part, or in
935 any entity licensed by this state or another state to provide
936 health or residential care, which facility or entity during the
937 5 years prior to the application for a license closed due to
938 financial inability to operate; had a receiver appointed or a
939 license denied, suspended, or revoked; was subject to a
940 moratorium; or had an injunctive proceeding initiated against
941 it.
942 (4) The agency shall deny or revoke the license of an
943 assisted living facility that has two or more class I violations
944 that are similar or identical to violations identified by the
945 agency during a survey, inspection, monitoring visit, or
946 complaint investigation occurring within the previous 2 years.
947 (4)(5) An action taken by the agency to suspend, deny, or
948 revoke a licensee’s facility’s license under this part or part
949 II of chapter 408, in which the agency claims that the facility
950 owner or a staff member an employee of the facility has
951 threatened the health, safety, or welfare of a resident of the
952 facility must be heard by the Division of Administrative
953 Hearings of the Department of Management Services within 120
954 days after receipt of the facility’s request for a hearing,
955 unless that time limitation is waived by both parties. The
956 administrative law judge must render a decision within 30 days
957 after receipt of a proposed recommended order.
958 (6) The agency shall provide to the Division of Hotels and
959 Restaurants of the Department of Business and Professional
960 Regulation, on a monthly basis, a list of those assisted living
961 facilities that have had their licenses denied, suspended, or
962 revoked or that are involved in an appellate proceeding pursuant
963 to s. 120.60 related to the denial, suspension, or revocation of
964 a license.
965 (5)(7) Agency notification of a license suspension or
966 revocation, or denial of a license renewal, shall be posted and
967 visible to the public at the facility.
968 Section 12. Subsections (1), (4), and (5) of section
969 429.17, Florida Statutes, are amended to read:
970 429.17 Expiration of license; renewal; conditional
971 license.—
972 (1) Limited nursing, Extended congregate care, and limited
973 mental health licenses shall expire at the same time as the
974 facility’s standard license, regardless of when issued.
975 (4) In addition to the license categories available in s.
976 408.808, a conditional license may be issued to an applicant for
977 license renewal if the applicant fails to meet all standards and
978 requirements for licensure. A conditional license issued under
979 this subsection shall be limited in duration to a specific
980 period of time not to exceed 6 months, as determined by the
981 agency, and shall be accompanied by an agency-approved plan of
982 correction.
983 (5) When an extended congregate care or limited nursing
984 license is requested during a facility’s biennial license
985 period, the fee shall be prorated in order to permit the
986 additional license to expire at the end of the biennial license
987 period. The fee shall be calculated as of the date the
988 additional license application is received by the agency.
989 Section 13. Subsections (1), (6), (7), and (8) of section
990 429.178, Florida Statutes, are amended to read:
991 429.178 Special care for persons with Alzheimer’s disease
992 or other related disorders.—
993 (1) A facility that which advertises that it provides
994 special care for persons with Alzheimer’s disease or other
995 related disorders must meet the following standards of
996 operation:
997 (a)1. If the facility has 17 or more residents, Have an
998 awake staff member on duty at all hours of the day and night for
999 each secured unit of the facility which houses any residents who
1000 have Alzheimer’s disease or other related disorders.; or
1001 2. If the facility has fewer than 17 residents, have an
1002 awake staff member on duty at all hours of the day and night or
1003 have mechanisms in place to monitor and ensure the safety of the
1004 facility’s residents.
1005 (b) Offer activities specifically designed for persons who
1006 are cognitively impaired.
1007 (c) Have a physical environment that provides for the
1008 safety and welfare of the facility’s residents.
1009 (d) Employ staff who have completed the training and
1010 continuing education required in subsection (2).
1011
1012 For the safety and protection of residents who have Alzheimer’s
1013 disease, related disorders, or dementia, a secured locked unit
1014 may be designated. The unit may consist of the entire building
1015 or a distinct part of the building. Exit doors shall be equipped
1016 with an operating alarm system that releases upon activation of
1017 the fire alarm. These units are exempt from specific life safety
1018 requirements to which assisted living facilities are normally
1019 subject. A staff member must be awake and present in the secured
1020 unit at all times.
1021 (6) The department shall maintain and post on its website
1022 keep a current list of providers who are approved to provide
1023 initial and continuing education for staff and direct care staff
1024 members of facilities that provide special care for persons with
1025 Alzheimer’s disease or other related disorders.
1026 (7) Any facility more than 90 percent of whose residents
1027 receive monthly optional supplementation payments is not
1028 required to pay for the training and education programs required
1029 under this section. A facility that has one or more such
1030 residents shall pay a reduced fee that is proportional to the
1031 percentage of such residents in the facility. A facility that
1032 does not have any residents who receive monthly optional
1033 supplementation payments must pay a reasonable fee, as
1034 established by the department, for such training and education
1035 programs.
1036 (7)(8) The department shall adopt rules to establish
1037 standards for trainers and training and to implement this
1038 section.
1039 Section 14. Subsections (1), (2), (5), (7), (8), and (9) of
1040 section 429.19, Florida Statutes, are amended to read:
1041 429.19 Violations; imposition of administrative fines;
1042 grounds.—
1043 (1) In addition to the requirements of part II of chapter
1044 408, the agency shall impose an administrative fine in the
1045 manner provided in chapter 120 for the violation of any
1046 provision of this part, part II of chapter 408, and applicable
1047 rules by an assisted living facility, for the actions of any
1048 person subject to level 2 background screening under s. 408.809,
1049 for the actions of any facility employee, or for an intentional
1050 or negligent act seriously affecting the health, safety, or
1051 welfare of a resident of the facility.
1052 (2) Each violation of this part and adopted rules shall be
1053 classified according to the nature of the violation and the
1054 gravity of its probable effect on facility residents. The agency
1055 shall indicate the classification on the written notice of the
1056 violation as follows:
1057 (a) Class “I” violations are those conditions or
1058 occurrences related to the operation and maintenance of a
1059 facility or to the care of residents which the agency determines
1060 present an imminent danger to the residents or a substantial
1061 probability that death or serious physical or emotional harm
1062 would result. The condition or practice that constitutes a class
1063 I violation must be abated or eliminated within 24 hours, unless
1064 a fixed period, as determined by the agency, is required for
1065 correction defined in s. 408.813. The agency shall impose an
1066 administrative fine for a cited class I violation in an amount
1067 not less than $5,000 and not exceeding $10,000 for each
1068 violation. A fine shall be levied notwithstanding the correction
1069 of the violation.
1070 (b) Class “II” violations are those conditions or
1071 occurrences related to the operation and maintenance of a
1072 facility or to the care of residents which the agency determines
1073 directly threaten the physical or emotional health, safety, or
1074 security of the residents, other than class I violations defined
1075 in s. 408.813. The agency shall impose an administrative fine
1076 for a cited class II violation in an amount not less than $1,000
1077 and not exceeding $5,000 for each violation. A fine shall be
1078 levied notwithstanding the correction of the violation.
1079 (c) Class “III” violations are those conditions or
1080 occurrences related to the operation and maintenance of a
1081 facility or to the care of residents which the agency determines
1082 indirectly or potentially threaten the physical or emotional
1083 health, safety, or security of residents, other than class I
1084 violations or class II violations defined in s. 408.813. The
1085 agency shall impose an administrative fine for a cited class III
1086 violation in an amount not less than $500 and not exceeding
1087 $1,000 for each violation. If a class III violation is corrected
1088 within the time specified, a fine may not be imposed.
1089 (d) Class “IV” violations are those conditions or
1090 occurrences related to the operation and maintenance of a
1091 facility or to required reports, forms, or documents which do
1092 not have the potential of negatively affecting residents. These
1093 violations are of a type that the agency determines do not
1094 threaten the health, safety, or security of residents defined in
1095 s. 408.813. The agency shall impose an administrative fine for a
1096 cited class IV violation in an amount not less than $100 and not
1097 exceeding $200 for each violation. A citation for a class IV
1098 violation must specify the time within which the violation is
1099 required to be corrected. If a class IV violation is corrected
1100 within the time specified, a fine may not be imposed.
1101 (5) Any action taken to correct a violation shall be
1102 documented in writing by the licensee owner or administrator of
1103 the facility and verified through followup visits by agency
1104 personnel or desk review. The agency may impose a fine and, in
1105 the case of an owner-operated facility, revoke or deny a
1106 licensee’s facility’s license when the agency has documented
1107 that a facility administrator has fraudulently misrepresented
1108 misrepresents action taken to correct a violation.
1109 (7) In addition to any administrative fines imposed, the
1110 agency may assess a survey fee, equal to the lesser of one half
1111 of the facility’s biennial license and bed fee or $500, to cover
1112 the cost of conducting initial complaint investigations that
1113 result in the finding of a violation that was the subject of the
1114 complaint or monitoring visits conducted under s. 429.28(3)(c)
1115 to verify the correction of the violations.
1116 (8) During an inspection, the agency shall make a
1117 reasonable attempt to discuss each violation with the owner or
1118 administrator of the facility before giving, prior to written
1119 notification.
1120 (9) The agency shall develop and disseminate an annual list
1121 of all facilities sanctioned or fined for violations of state
1122 standards, the number and class of violations involved, the
1123 penalties imposed, and the current status of cases. The list
1124 shall be disseminated, at no charge, to the Department of
1125 Elderly Affairs, the Department of Health, the Department of
1126 Children and Family Services, the Agency for Persons with
1127 Disabilities, the area agencies on aging, the Florida Statewide
1128 Advocacy Council, and the state and local ombudsman councils.
1129 The Department of Children and Family Services shall disseminate
1130 the list to service providers under contract to the department
1131 who are responsible for referring persons to a facility for
1132 residency. The agency may charge a fee commensurate with the
1133 cost of printing and postage to other interested parties
1134 requesting a copy of this list. This information may be provided
1135 electronically or through the agency’s Internet site.
1136 Section 15. Section 429.195, Florida Statutes, is amended
1137 to read:
1138 429.195 Rebates prohibited; penalties.—
1139 (1) It is unlawful for the licensee of any assisted living
1140 facility licensed under this part to contract or promise to pay
1141 or receive any commission, bonus, kickback, or rebate or engage
1142 in any split-fee arrangement in any form whatsoever with any
1143 health care provider or health care facility under s. 817.505
1144 physician, surgeon, organization, agency, or person, either
1145 directly or indirectly, for residents referred to an assisted
1146 living facility licensed under this part. A facility may employ
1147 or contract with persons to market the facility, provided the
1148 employee or contract provider clearly indicates that he or she
1149 represents the facility. A person or agency independent of the
1150 facility may provide placement or referral services for a fee to
1151 individuals seeking assistance in finding a suitable facility;
1152 however, any fee paid for placement or referral services must be
1153 paid by the individual looking for a facility, not by the
1154 facility.
1155 (2) A violation of this section shall be considered patient
1156 brokering and is punishable as provided in s. 817.505.
1157 (3) This section does not apply to:
1158 (a) Any individual with whom the facility employs or
1159 contracts with to market the facility if the employee or
1160 contract provider clearly indicates that he or she works with or
1161 for the facility.
1162 (b) A referral service that provides information,
1163 consultation, or referrals to consumers to assist them in
1164 finding appropriate care or housing options for seniors or
1165 disabled adults if such referred consumers are not Medicaid
1166 recipients.
1167 (c) A resident of an assisted living facility who refers to
1168 the assisted living facility a friend, a family member, or other
1169 individual with whom the resident has a personal relationship.
1170 Such a referral does not prohibit the assisted living facility
1171 from providing a monetary reward to the resident for making such
1172 a referral.
1173 Section 16. Subsections (2) and (3) of section 429.20,
1174 Florida Statutes, are amended to read:
1175 429.20 Certain solicitation prohibited; third-party
1176 supplementation.—
1177 (2) Solicitation of contributions of any kind in a
1178 threatening, coercive, or unduly forceful manner by or on behalf
1179 of an assisted living facility or facilities by any agent,
1180 employee, owner, or representative of any assisted living
1181 facility or facilities is prohibited grounds for denial,
1182 suspension, or revocation of the license of the assisted living
1183 facility or facilities by or on behalf of which such
1184 contributions were solicited.
1185 (3) The admission or maintenance of assisted living
1186 facility residents whose care is supported, in whole or in part,
1187 by state funds may not be conditioned upon the receipt of any
1188 manner of contribution or donation from any person. The
1189 solicitation or receipt of contributions in violation of this
1190 subsection is grounds for denial, suspension, or revocation of
1191 license, as provided in s. 429.14, for any assisted living
1192 facility by or on behalf of which such contributions were
1193 solicited.
1194 Section 17. Section 429.23, Florida Statutes, is amended to
1195 read:
1196 429.23 Internal risk management and quality assurance
1197 program; adverse incidents and reporting requirements.—
1198 (1) Every licensed facility licensed under this part may,
1199 as part of its administrative functions, voluntarily establish a
1200 risk management and quality assurance program, the purpose of
1201 which is to assess resident care practices, facility incident
1202 reports, violations deficiencies cited by the agency, adverse
1203 incident reports, and resident grievances and develop plans of
1204 action to correct and respond quickly to identify quality
1205 differences.
1206 (2) Every licensed facility licensed under this part is
1207 required to maintain adverse incident reports. For purposes of
1208 this section, the term, “adverse incident” means:
1209 (a) An event over which facility staff personnel could
1210 exercise control rather than as a result of the resident’s
1211 condition and results in:
1212 1. Death;
1213 2. Brain or spinal damage;
1214 3. Permanent disfigurement;
1215 4. Fracture or dislocation of bones or joints;
1216 5. Any condition that required medical attention to which
1217 the resident has not given his or her consent, excluding
1218 proceedings governed by part I of chapter 394, but including
1219 failure to honor advanced directives;
1220 6. Any condition that requires the transfer of the resident
1221 from the facility to a unit providing more acute care due to the
1222 incident rather than the resident’s condition before the
1223 incident; or
1224 7. An event that is reported to law enforcement or its
1225 personnel for investigation; or
1226 (b) Resident elopement, if the elopement places the
1227 resident at risk of harm or injury.
1228 (3) Licensed facilities shall provide within 1 business day
1229 after the occurrence of an adverse incident, by electronic mail,
1230 facsimile, or United States mail, a preliminary report to the
1231 agency on all adverse incidents specified under this section.
1232 The report must include information regarding the identity of
1233 the affected resident, the type of adverse incident, and the
1234 status of the facility’s investigation of the incident.
1235 (3)(4) A licensed facility Licensed facilities shall
1236 provide within 15 business days after the occurrence of an
1237 adverse incident, by electronic mail, facsimile, or United
1238 States mail, a full report to the agency on the all adverse
1239 incident, including information regarding the identity of the
1240 affected resident, the type of adverse incident, and incidents
1241 specified in this section. The report must include the results
1242 of the facility’s investigation into the adverse incident.
1243 (5) Each facility shall report monthly to the agency any
1244 liability claim filed against it. The report must include the
1245 name of the resident, the dates of the incident leading to the
1246 claim, if applicable, and the type of injury or violation of
1247 rights alleged to have occurred. This report is not discoverable
1248 in any civil or administrative action, except in such actions
1249 brought by the agency to enforce the provisions of this part.
1250 (4)(6) Abuse, neglect, or exploitation must be reported to
1251 the Department of Children and Family Services as required under
1252 chapter 415.
1253 (5)(7) The information reported to the agency pursuant to
1254 subsection (3) which relates to persons licensed under chapter
1255 458, chapter 459, chapter 461, chapter 464, or chapter 465 must
1256 shall be reviewed by the agency. The agency shall determine
1257 whether any of the incidents potentially involved conduct by a
1258 health care professional who is subject to disciplinary action,
1259 in which case the provisions of s. 456.073 apply. The agency may
1260 investigate, as it deems appropriate, any such incident and
1261 prescribe measures that must or may be taken in response to the
1262 incident. The agency shall review each incident and determine
1263 whether it potentially involved conduct by a health care
1264 professional who is subject to disciplinary action, in which
1265 case the provisions of s. 456.073 apply.
1266 (6)(8) If the agency, through its receipt of the adverse
1267 incident reports prescribed in this part or through any
1268 investigation, has reasonable belief that conduct by a staff
1269 member or employee of a licensed facility is grounds for
1270 disciplinary action by the appropriate board, the agency shall
1271 report this fact to such regulatory board.
1272 (7)(9) The adverse incident report reports and preliminary
1273 adverse incident reports required under this section is are
1274 confidential as provided by law and is are not discoverable or
1275 admissible in any civil or administrative action, except in
1276 disciplinary proceedings by the agency or appropriate regulatory
1277 board.
1278 (8)(10) The Department of Elderly Affairs may adopt rules
1279 necessary to administer this section.
1280 Section 18. Subsections (1) and (2) of section 429.255,
1281 Florida Statutes, are amended to read:
1282 429.255 Use of personnel; emergency care.—
1283 (1)(a) Persons under contract to the facility or, facility
1284 staff, or volunteers, who are licensed according to part I of
1285 chapter 464, or those persons exempt under s. 464.022(1), and
1286 others as defined by rule, may administer medications to
1287 residents, take residents’ vital signs, manage individual weekly
1288 pill organizers for residents who self-administer medication,
1289 give prepackaged enemas ordered by a physician, observe
1290 residents, document observations on the appropriate resident’s
1291 record, report observations to the resident’s physician, and
1292 contract or allow residents or a resident’s representative,
1293 designee, surrogate, guardian, or attorney in fact to contract
1294 with a third party, provided residents meet the criteria for
1295 appropriate placement as defined in s. 429.26. Nursing
1296 assistants certified pursuant to part II of chapter 464 may take
1297 residents’ vital signs as directed by a licensed nurse or
1298 physician. A person under contract to the facility or facility
1299 staff who is licensed under part I of chapter 464 may provide
1300 limited nursing services.
1301 (b) All staff in facilities licensed under this part shall
1302 exercise their professional responsibility to observe residents,
1303 to document observations on the appropriate resident’s record,
1304 and to report the observations to the administrator or the
1305 administrator’s designee resident’s physician. However, The
1306 owner or administrator of the facility shall be responsible for
1307 determining that the resident receiving services is appropriate
1308 for residence in the assisted living facility.
1309 (c) In an emergency situation, licensed personnel may carry
1310 out their professional duties pursuant to part I of chapter 464
1311 until emergency medical personnel assume responsibility for
1312 care.
1313 (2) In facilities licensed to provide extended congregate
1314 care, persons under contract to the facility or, facility staff,
1315 or volunteers, who are licensed according to part I of chapter
1316 464, or those persons exempt under s. 464.022(1), or those
1317 persons certified as nursing assistants pursuant to part II of
1318 chapter 464, may also perform all duties within the scope of
1319 their license or certification, as approved by the facility
1320 administrator and pursuant to this part.
1321 Section 19. Subsections (2), (3), and (4) of section
1322 429.256, Florida Statutes, are amended to read:
1323 429.256 Assistance with self-administration of medication.—
1324 (2) Residents who are capable of self-administering their
1325 own medications without assistance shall be encouraged and
1326 allowed to do so. However, an unlicensed person may, consistent
1327 with a dispensed prescription’s label or the package directions
1328 of an over-the-counter medication, assist a resident whose
1329 condition is medically stable with the self-administration of
1330 routine, regularly scheduled medications that are intended to be
1331 self-administered. Assistance with self-medication by an
1332 unlicensed person may occur only upon a documented request by,
1333 and the written informed consent of, a resident or the
1334 resident’s surrogate, guardian, or attorney in fact. To minimize
1335 the potential risk for improper dosage administration of
1336 prescription drugs, a facility may require standard-medication
1337 dispensing systems for residents’ prescriptions, as specified by
1338 rule. For the purposes of this section, self-administered
1339 medications include both legend and over-the-counter oral dosage
1340 forms, topical dosage forms and topical ophthalmic, otic, and
1341 nasal dosage forms including solutions, suspensions, sprays, and
1342 inhalers, and continuous positive airway pressure machines.
1343 (3) Assistance with self-administration of medication
1344 includes:
1345 (a) Taking the medication, in its previously dispensed,
1346 properly labeled container, from where it is stored, and
1347 bringing it to the resident.
1348 (b) In the presence of the resident, reading the label,
1349 opening the container, removing a prescribed amount of
1350 medication from the container, and closing the container.
1351 (c) Placing an oral dosage in the resident’s hand or
1352 placing the dosage in another container and helping the resident
1353 by lifting the container to his or her mouth.
1354 (d) Applying topical medications.
1355 (e) Returning the medication container to proper storage.
1356 (f) Keeping a record of when a resident receives assistance
1357 with self-administration under this section.
1358 (g) Assisting a resident in holding a nebulizer.
1359 (h) Using a glucometer to perform blood glucose checks.
1360 (i) Assisting with the putting on and taking off anti
1361 embolism stockings.
1362 (j) Assisting with applying and removing an oxygen cannula.
1363 (4) Assistance with self-administration does not include:
1364 (a) Mixing, compounding, converting, or calculating
1365 medication doses, except for measuring a prescribed amount of
1366 liquid medication or breaking a scored tablet or crushing a
1367 tablet as prescribed.
1368 (b) The preparation of syringes for injection or the
1369 administration of medications by any injectable route.
1370 (c) Administration of medications through intermittent
1371 positive pressure breathing machines or a nebulizer.
1372 (c)(d) Administration of medications by way of a tube
1373 inserted in a cavity of the body.
1374 (d)(e) Administration of parenteral preparations.
1375 (e)(f) Irrigations or debriding agents used in the
1376 treatment of a skin condition.
1377 (f)(g) Rectal, urethral, or vaginal preparations.
1378 (g)(h) Medications ordered by the physician or health care
1379 professional with prescriptive authority to be given “as
1380 needed,” unless the order is written with specific parameters
1381 that preclude independent judgment on the part of the unlicensed
1382 person, and at the request of a competent resident.
1383 (h)(i) Medications for which the time of administration,
1384 the amount, the strength of dosage, the method of
1385 administration, or the reason for administration requires
1386 judgment or discretion on the part of the unlicensed person.
1387 Section 20. Subsections (3), (7), (8), (9), (10), and (11)
1388 of section 429.26, Florida Statutes, are amended to read:
1389 429.26 Appropriateness of placements; examinations of
1390 residents.—
1391 (3) Persons licensed under part I of chapter 464 who are
1392 employed by or under contract with a facility shall, on a
1393 routine basis or at least monthly, perform a nursing assessment
1394 of the residents for whom they are providing nursing services
1395 ordered by a physician, except administration of medication, and
1396 shall document such assessment, including any significant change
1397 substantial changes in a resident’s status which may necessitate
1398 relocation to a nursing home, hospital, or specialized health
1399 care facility. Such records shall be maintained in the facility
1400 for inspection by the agency and shall be forwarded to the
1401 resident’s case manager, if applicable.
1402 (7) The facility must notify a licensed physician when a
1403 resident exhibits signs of dementia or cognitive impairment or
1404 has a change of condition in order to rule out the presence of
1405 an underlying physiological condition that may be contributing
1406 to such dementia or impairment. The notification must occur
1407 within 30 days after the acknowledgment of such signs by
1408 facility staff. If an underlying condition is determined to
1409 exist, the facility shall arrange, with the appropriate health
1410 care provider, the necessary care and services to treat the
1411 condition.
1412 (7)(8) The Department of Children and Family Services may
1413 require an examination for supplemental security income and
1414 optional state supplementation recipients residing in facilities
1415 at any time and shall provide the examination whenever a
1416 resident’s condition requires it. Any facility administrator;
1417 personnel of the agency, the department, or the Department of
1418 Children and Family Services; or long-term care ombudsman
1419 council member who believes a resident needs to be evaluated
1420 shall notify the resident’s case manager, who shall take
1421 appropriate action. A report of the examination findings shall
1422 be provided to the resident’s case manager and the facility
1423 administrator to help the administrator meet his or her
1424 responsibilities under subsection (1).
1425 (8)(9) A terminally ill resident who no longer meets the
1426 criteria for continued residency may remain in the facility if
1427 the arrangement is mutually agreeable to the resident and the
1428 administrator facility; additional care is rendered through a
1429 licensed hospice, and the resident is under the care of a
1430 physician who agrees that the physical needs of the resident are
1431 being met.
1432 (9)(10) Facilities licensed to provide extended congregate
1433 care services shall promote aging in place by determining
1434 appropriateness of continued residency based on a comprehensive
1435 review of the resident’s physical and functional status; the
1436 ability of the facility, family members, friends, or any other
1437 pertinent individuals or agencies to provide the care and
1438 services required; and documentation that a written service plan
1439 consistent with facility policy has been developed and
1440 implemented to ensure that the resident’s needs and preferences
1441 are addressed.
1442 (10)(11) A No resident who requires 24-hour nursing
1443 supervision, except for a resident who is an enrolled hospice
1444 patient pursuant to part IV of chapter 400, may not shall be
1445 retained in a licensed facility licensed under this part.
1446 Section 21. Section 429.27, Florida Statutes, is amended to
1447 read:
1448 429.27 Property and personal affairs of residents.—
1449 (1)(a) A resident shall be given the option of using his or
1450 her own belongings, as space permits; choosing his or her
1451 roommate; and, whenever possible, unless the resident is
1452 adjudicated incompetent or incapacitated under state law,
1453 managing his or her own affairs.
1454 (b) The admission of a resident to a facility and his or
1455 her presence therein does shall not give confer on the facility
1456 or its licensee, owner, administrator, employees, or
1457 representatives any authority to manage, use, or dispose of any
1458 property of the resident; nor shall such admission or presence
1459 give confer on any of such persons any authority or
1460 responsibility for the personal affairs of the resident, except
1461 that which may be necessary for the safe management of the
1462 facility or for the safety of the resident.
1463 (2) The licensee, A facility, or an owner, administrator,
1464 employee of an assisted living facility, or representative
1465 thereof, may not act as the guardian, trustee, or conservator
1466 for any resident of the assisted living facility or any of such
1467 resident’s property. A licensee, An owner, administrator, or
1468 staff member, or representative thereof, may not act as a
1469 competent resident’s payee for social security, veteran’s, or
1470 railroad benefits without the consent of the resident. Any
1471 facility whose licensee, owner, administrator, or staff, or
1472 representative thereof, serves as representative payee for any
1473 resident of the facility shall file a surety bond with the
1474 agency in an amount equal to twice the average monthly aggregate
1475 income or personal funds due to residents, or expendable for
1476 their account, which are received by a facility. Any facility
1477 whose licensee, owner, administrator, or staff, or a
1478 representative thereof, is granted power of attorney for any
1479 resident of the facility shall file a surety bond with the
1480 agency for each resident for whom such power of attorney is
1481 granted. The surety bond shall be in an amount equal to twice
1482 the average monthly income of the resident, plus the value of
1483 any resident’s property under the control of the attorney in
1484 fact. The bond shall be executed by the facility’s licensee,
1485 owner, administrator, or staff, or a representative thereof,
1486 facility as principal and a licensed surety company. The bond
1487 shall be conditioned upon the faithful compliance of the
1488 licensee, owner, administrator, or staff, or a representative
1489 thereof, of the facility with this section and shall run to the
1490 agency for the benefit of any resident who suffers a financial
1491 loss as a result of the misuse or misappropriation by a
1492 licensee, owner, administrator, or staff, or representative
1493 thereof, of the facility of funds held pursuant to this
1494 subsection. Any surety company that cancels or does not renew
1495 the bond of any licensee shall notify the agency in writing not
1496 less than 30 days in advance of such action, giving the reason
1497 for the cancellation or nonrenewal. Any facility’s licensee,
1498 facility owner, administrator, or staff, or representative
1499 thereof, who is granted power of attorney for any resident of
1500 the facility shall, on a monthly basis, be required to provide
1501 the resident a written statement of any transaction made on
1502 behalf of the resident pursuant to this subsection, and a copy
1503 of such statement given to the resident shall be retained in
1504 each resident’s file and available for agency inspection.
1505 (3) A facility’s administrator facility, upon mutual
1506 consent with the resident, shall provide for the safekeeping in
1507 the facility of personal effects, including funds not in excess
1508 of $500 and funds of the resident not in excess of $200 cash,
1509 and shall keep complete and accurate records of all such funds
1510 and personal effects received. If a resident is absent from a
1511 facility for 24 hours or more, the facility may provide for the
1512 safekeeping of the resident’s personal effects, including funds
1513 in excess of $500.
1514 (4) Any funds or other property belonging to or due to a
1515 resident, or expendable for his or her account, which is
1516 received by the administrator a facility shall be trust funds
1517 which shall be kept separate from the funds and property of the
1518 facility and other residents or shall be specifically credited
1519 to such resident. Such trust funds shall be used or otherwise
1520 expended only for the account of the resident. Upon written
1521 request, at least once every 3 months, unless upon order of a
1522 court of competent jurisdiction, the administrator facility
1523 shall furnish the resident and his or her guardian, trustee, or
1524 conservator, if any, a complete and verified statement of all
1525 funds and other property to which this subsection applies,
1526 detailing the amount and items received, together with their
1527 sources and disposition. In any event, the administrator
1528 facility shall furnish such statement annually and upon the
1529 discharge or transfer of a resident. Any governmental agency or
1530 private charitable agency contributing funds or other property
1531 to the account of a resident shall also be entitled to receive
1532 such statement annually and upon the discharge or transfer of
1533 the resident.
1534 (5) Any personal funds available to facility residents may
1535 be used by residents as they choose to obtain clothing, personal
1536 items, leisure activities, and other supplies and services for
1537 their personal use. An administrator A facility may not demand,
1538 require, or contract for payment of all or any part of the
1539 personal funds in satisfaction of the facility rate for supplies
1540 and services beyond that amount agreed to in writing and may not
1541 levy an additional charge to the individual or the account for
1542 any supplies or services that the facility has agreed by
1543 contract to provide as part of the standard monthly rate. Any
1544 service or supplies provided by the facility which are charged
1545 separately to the individual or the account may be provided only
1546 with the specific written consent of the individual, who shall
1547 be furnished in advance of the provision of the services or
1548 supplies with an itemized written statement to be attached to
1549 the contract setting forth the charges for the services or
1550 supplies.
1551 (6)(a) In addition to any damages or civil penalties to
1552 which a person is subject, any person who:
1553 1. Intentionally withholds a resident’s personal funds,
1554 personal property, or personal needs allowance, or who demands,
1555 beneficially receives, or contracts for payment of all or any
1556 part of a resident’s personal property or personal needs
1557 allowance in satisfaction of the facility rate for supplies and
1558 services; or
1559 2. Borrows from or pledges any personal funds of a
1560 resident, other than the amount agreed to by written contract
1561 under s. 429.24,
1562
1563 commits a misdemeanor of the first degree, punishable as
1564 provided in s. 775.082 or s. 775.083.
1565 (b) Any licensee, facility owner, administrator, or staff,
1566 or representative thereof, who is granted power of attorney for
1567 any resident of the facility and who misuses or misappropriates
1568 funds obtained through this power commits a felony of the third
1569 degree, punishable as provided in s. 775.082, s. 775.083, or s.
1570 775.084.
1571 (7) In the event of the death of a resident, a licensee
1572 shall return all refunds, funds, and property held in trust to
1573 the resident’s personal representative, if one has been
1574 appointed at the time the facility disburses such funds, and, if
1575 not, to the resident’s spouse or adult next of kin named in a
1576 beneficiary designation form provided by the licensee facility
1577 to the resident. If the resident has no spouse or adult next of
1578 kin or such person cannot be located, funds due the resident
1579 shall be placed in an interest-bearing account, and all property
1580 held in trust by the licensee facility shall be safeguarded
1581 until such time as the funds and property are disbursed pursuant
1582 to the Florida Probate Code. Such funds shall be kept separate
1583 from the funds and property of the facility and other residents
1584 of the facility. If the funds of the deceased resident are not
1585 disbursed pursuant to the Florida Probate Code within 2 years
1586 after the resident’s death, the funds shall be deposited in the
1587 Health Care Trust Fund administered by the agency.
1588 (8) The department may by rule clarify terms and specify
1589 procedures and documentation necessary to administer the
1590 provisions of this section relating to the proper management of
1591 residents’ funds and personal property and the execution of
1592 surety bonds.
1593 Section 22. Subsection (4) of section 429.275, Florida
1594 Statutes, is repealed.
1595 Section 23. Paragraph (k) of subsection (1) and subsections
1596 (3), (4), (5), (6), and (7) of section 429.28, Florida Statutes,
1597 are amended to read:
1598 429.28 Resident bill of rights.—
1599 (1) A No resident of a facility may not shall be deprived
1600 of any civil or legal rights, benefits, or privileges guaranteed
1601 by law, the Constitution of the State of Florida, or the
1602 Constitution of the United States as a resident of a facility.
1603 Every resident of a facility shall have the right to:
1604 (k) At least 30 45 days’ notice of relocation or
1605 termination of residency from the facility unless, for medical
1606 reasons, the resident is certified by a physician to require an
1607 emergency relocation to a facility providing a more skilled
1608 level of care or the resident engages in a pattern of conduct
1609 that is harmful or offensive to other residents. In the case of
1610 a resident who has been adjudicated mentally incapacitated, the
1611 guardian shall be given at least 30 45 days’ notice of a
1612 nonemergency relocation or residency termination. Reasons for
1613 relocation shall be set forth in writing. In order for a
1614 facility to terminate the residency of an individual without
1615 notice as provided herein, the facility shall show good cause in
1616 a court of competent jurisdiction.
1617 (3)(a) The agency shall conduct a survey to determine
1618 general compliance with facility standards and compliance with
1619 residents’ rights as a prerequisite to initial licensure or
1620 licensure renewal.
1621 (b) In order to determine whether the facility is
1622 adequately protecting residents’ rights, the biennial survey
1623 shall include private informal conversations with a sample of
1624 residents and consultation with the ombudsman council in the
1625 planning and service area in which the facility is located to
1626 discuss residents’ experiences within the facility.
1627 (c) During any calendar year in which no survey is
1628 conducted, the agency shall conduct at least one monitoring
1629 visit of each facility cited in the previous year for a class I
1630 or class II violation, or more than three uncorrected class III
1631 violations.
1632 (d) The agency may conduct periodic followup inspections as
1633 necessary to monitor the compliance of facilities with a history
1634 of any class I, class II, or class III violations that threaten
1635 the health, safety, or security of residents.
1636 (e) The agency may conduct complaint investigations as
1637 warranted to investigate any allegations of noncompliance with
1638 requirements required under this part or rules adopted under
1639 this part.
1640 (3)(4) The administrator shall ensure that facility shall
1641 not hamper or prevent residents may exercise from exercising
1642 their rights as specified in this section.
1643 (4)(5) A staff member No facility or employee of a facility
1644 may not serve notice upon a resident to leave the premises or
1645 take any other retaliatory action against any person who:
1646 (a) Exercises any right set forth in this section.
1647 (b) Appears as a witness in any hearing, inside or outside
1648 the facility.
1649 (c) Files a civil action alleging a violation of the
1650 provisions of this part or notifies a state attorney or the
1651 Attorney General of a possible violation of such provisions.
1652 (5)(6) An administrator may not terminate Any facility
1653 which terminates the residency of an individual who participated
1654 in activities specified in subsection (4) (5) shall show good
1655 cause in a court of competent jurisdiction.
1656 (6)(7) Any person who submits or reports a complaint
1657 concerning a suspected violation of the provisions of this part
1658 or concerning services and conditions in facilities, or who
1659 testifies in any administrative or judicial proceeding arising
1660 from such a complaint, shall have immunity from any civil or
1661 criminal liability therefor, unless such person has acted in bad
1662 faith or with malicious purpose or the court finds that there
1663 was a complete absence of a justiciable issue of either law or
1664 fact raised by the losing party.
1665 Section 24. Paragraphs (a), (d), (h), (i), (j), and (l) of
1666 subsection (1) and subsection (5) of section 429.41, Florida
1667 Statutes, are amended to read:
1668 429.41 Rules establishing standards.—
1669 (1) It is the intent of the Legislature that rules
1670 published and enforced pursuant to this section shall include
1671 criteria by which a reasonable and consistent quality of
1672 resident care and quality of life may be ensured and the results
1673 of such resident care may be demonstrated. Such rules shall also
1674 ensure a safe and sanitary environment that is residential and
1675 noninstitutional in design or nature. It is further intended
1676 that reasonable efforts be made to accommodate the needs and
1677 preferences of residents to enhance the quality of life in a
1678 facility. The agency, in consultation with the department, may
1679 adopt rules to administer the requirements of part II of chapter
1680 408. In order to provide safe and sanitary facilities and the
1681 highest quality of resident care accommodating the needs and
1682 preferences of residents, the department, in consultation with
1683 the agency, the Department of Children and Family Services, and
1684 the Department of Health, shall adopt rules, policies, and
1685 procedures to administer this part, which must include
1686 reasonable and fair minimum standards in relation to:
1687 (a) The requirements for and maintenance of facilities, not
1688 in conflict with the provisions of chapter 553, relating to
1689 plumbing, heating, cooling, lighting, ventilation, living space,
1690 and other housing conditions, which will ensure the health,
1691 safety, and comfort of residents and protection from fire
1692 hazard, including adequate provisions for fire alarm and other
1693 fire protection suitable to the size of the structure. Uniform
1694 firesafety standards shall be established and enforced by the
1695 State Fire Marshal in cooperation with the agency, the
1696 department, and the Department of Health.
1697 1. Evacuation capability determination.—
1698 a. The provisions of the National Fire Protection
1699 Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
1700 for determining the ability of the residents, with or without
1701 staff assistance, to relocate from or within a licensed facility
1702 to a point of safety as provided in the fire codes adopted
1703 herein. An evacuation capability evaluation for initial
1704 licensure shall be conducted within 6 months after the date of
1705 licensure. For existing licensed facilities that are not
1706 equipped with an automatic fire sprinkler system, the
1707 administrator shall evaluate the evacuation capability of
1708 residents at least annually. The evacuation capability
1709 evaluation for each facility not equipped with an automatic fire
1710 sprinkler system shall be validated, without liability, by the
1711 State Fire Marshal, by the local fire marshal, or by the local
1712 authority having jurisdiction over firesafety, before the
1713 license renewal date. If the State Fire Marshal, local fire
1714 marshal, or local authority having jurisdiction over firesafety
1715 has reason to believe that the evacuation capability of a
1716 facility as reported by the administrator may have changed, it
1717 may, with assistance from the facility administrator, reevaluate
1718 the evacuation capability through timed exiting drills.
1719 Translation of timed fire exiting drills to evacuation
1720 capability may be determined:
1721 (I) Three minutes or less: prompt.
1722 (II) More than 3 minutes, but not more than 13 minutes:
1723 slow.
1724 (III) More than 13 minutes: impractical.
1725 b. The Office of the State Fire Marshal shall provide or
1726 cause the provision of training and education on the proper
1727 application of Chapter 5, NFPA 101A, 1995 edition, to its
1728 employees, to staff of the Agency for Health Care Administration
1729 who are responsible for regulating facilities under this part,
1730 and to local governmental inspectors. The Office of the State
1731 Fire Marshal shall provide or cause the provision of this
1732 training within its existing budget, but may charge a fee for
1733 this training to offset its costs. The initial training must be
1734 delivered within 6 months after July 1, 1995, and as needed
1735 thereafter.
1736 c. The Office of the State Fire Marshal, in cooperation
1737 with provider associations, shall provide or cause the provision
1738 of a training program designed to inform facility operators on
1739 how to properly review bid documents relating to the
1740 installation of automatic fire sprinklers. The Office of the
1741 State Fire Marshal shall provide or cause the provision of this
1742 training within its existing budget, but may charge a fee for
1743 this training to offset its costs. The initial training must be
1744 delivered within 6 months after July 1, 1995, and as needed
1745 thereafter.
1746 d. The administrator of a licensed facility shall sign an
1747 affidavit verifying the number of residents occupying the
1748 facility at the time of the evacuation capability evaluation.
1749 2. Firesafety requirements.—
1750 a. Except for the special applications provided herein,
1751 effective January 1, 1996, the provisions of the National Fire
1752 Protection Association, Life Safety Code, NFPA 101, 1994
1753 edition, Chapter 22 for new facilities and Chapter 23 for
1754 existing facilities shall be the uniform fire code applied by
1755 the State Fire Marshal for assisted living facilities, pursuant
1756 to s. 633.022.
1757 b. Any new facility, regardless of size, that applies for a
1758 license on or after January 1, 1996, must be equipped with an
1759 automatic fire sprinkler system. The exceptions as provided in
1760 s. 22-2.3.5.1, NFPA 101, 1994 edition, as adopted herein, apply
1761 to any new facility housing eight or fewer residents. On July 1,
1762 1995, local governmental entities responsible for the issuance
1763 of permits for construction shall inform, without liability, any
1764 facility whose permit for construction is obtained prior to
1765 January 1, 1996, of this automatic fire sprinkler requirement.
1766 As used in this part, the term “a new facility” does not mean an
1767 existing facility that has undergone change of ownership.
1768 c. Notwithstanding any provision of s. 633.022 or of the
1769 National Fire Protection Association, NFPA 101A, Chapter 5, 1995
1770 edition, to the contrary, any existing facility housing eight or
1771 fewer residents is not required to install an automatic fire
1772 sprinkler system, nor to comply with any other requirement in
1773 Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety
1774 requirements of NFPA 101, 1988 edition, that applies to this
1775 size facility, unless the facility has been classified as
1776 impractical to evacuate. Any existing facility housing eight or
1777 fewer residents that is classified as impractical to evacuate
1778 must install an automatic fire sprinkler system within the
1779 timeframes granted in this section.
1780 d. Any existing facility that is required to install an
1781 automatic fire sprinkler system under this paragraph need not
1782 meet other firesafety requirements of Chapter 23, NFPA 101, 1994
1783 edition, which exceed the provisions of NFPA 101, 1988 edition.
1784 The mandate contained in this paragraph which requires certain
1785 facilities to install an automatic fire sprinkler system
1786 supersedes any other requirement.
1787 e. This paragraph does not supersede the exceptions granted
1788 in NFPA 101, 1988 edition or 1994 edition.
1789 f. This paragraph does not exempt a facility facilities
1790 from other firesafety provisions adopted under s. 633.022 and
1791 local building code requirements in effect before July 1, 1995.
1792 g. A local government may charge fees only in an amount not
1793 to exceed the actual expenses incurred by local government
1794 relating to the installation and maintenance of an automatic
1795 fire sprinkler system in an existing and properly licensed
1796 assisted living facility structure as of January 1, 1996.
1797 h. If a licensed facility undergoes major reconstruction or
1798 addition to an existing building on or after January 1, 1996,
1799 the entire building must be equipped with an automatic fire
1800 sprinkler system. Major reconstruction of a building means
1801 repair or restoration that costs in excess of 50 percent of the
1802 value of the building as reported on the tax rolls, excluding
1803 land, before reconstruction. Multiple reconstruction projects
1804 within a 5-year period the total costs of which exceed 50
1805 percent of the initial value of the building at the time the
1806 first reconstruction project was permitted are to be considered
1807 as major reconstruction. Application for a permit for an
1808 automatic fire sprinkler system is required upon application for
1809 a permit for a reconstruction project that creates costs that go
1810 over the 50 percent 50-percent threshold.
1811 i. Any facility licensed before January 1, 1996, that is
1812 required to install an automatic fire sprinkler system shall
1813 ensure that the installation is completed within the following
1814 timeframes based upon evacuation capability of the facility as
1815 determined under subparagraph 1.:
1816 (I) Impractical evacuation capability, 24 months.
1817 (II) Slow evacuation capability, 48 months.
1818 (III) Prompt evacuation capability, 60 months.
1819
1820 The beginning date from which the deadline for the automatic
1821 fire sprinkler installation requirement must be calculated is
1822 upon receipt of written notice from the local fire official that
1823 an automatic fire sprinkler system must be installed. The local
1824 fire official shall send a copy of the document indicating the
1825 requirement of a fire sprinkler system to the Agency for Health
1826 Care Administration.
1827 j. It is recognized that the installation of an automatic
1828 fire sprinkler system may create financial hardship for some
1829 facilities. The appropriate local fire official shall, without
1830 liability, grant two 1-year extensions to the timeframes for
1831 installation established herein, if an automatic fire sprinkler
1832 installation cost estimate and proof of denial from two
1833 financial institutions for a construction loan to install the
1834 automatic fire sprinkler system are submitted. However, for any
1835 facility with a class I or class II, or a history of uncorrected
1836 class III, firesafety deficiencies, an extension must not be
1837 granted. The local fire official shall send a copy of the
1838 document granting the time extension to the Agency for Health
1839 Care Administration.
1840 k. A facility owner whose facility is required to be
1841 equipped with an automatic fire sprinkler system under Chapter
1842 23, NFPA 101, 1994 edition, as adopted herein, must disclose to
1843 any potential buyer of the facility that an installation of an
1844 automatic fire sprinkler requirement exists. The sale of the
1845 facility does not alter the timeframe for the installation of
1846 the automatic fire sprinkler system.
1847 l. An existing facility facilities required to install an
1848 automatic fire sprinkler system as a result of construction-type
1849 restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
1850 herein, or evacuation capability requirements shall be notified
1851 by the local fire official in writing of the automatic fire
1852 sprinkler requirement, as well as the appropriate date for final
1853 compliance as provided in this subparagraph. The local fire
1854 official shall send a copy of the document to the Agency for
1855 Health Care Administration.
1856 m. Except in cases of life-threatening fire hazards, if an
1857 existing facility experiences a change in the evacuation
1858 capability, or if the local authority having jurisdiction
1859 identifies a construction-type restriction, such that an
1860 automatic fire sprinkler system is required, it shall be
1861 afforded time for installation as provided in this subparagraph.
1862
1863 Facilities that are fully sprinkled and in compliance with other
1864 firesafety standards are not required to conduct more than one
1865 of the required fire drills between the hours of 11 p.m. and 7
1866 a.m., per year. In lieu of the remaining drills, staff
1867 responsible for residents during such hours may be required to
1868 participate in a mock drill that includes a review of evacuation
1869 procedures. Such standards must be included or referenced in the
1870 rules adopted by the State Fire Marshal. Pursuant to s.
1871 633.022(1)(b), the State Fire Marshal is the final
1872 administrative authority for firesafety standards established
1873 and enforced pursuant to this section. All licensed facilities
1874 must have an annual fire inspection conducted by the local fire
1875 marshal or authority having jurisdiction.
1876 3. Resident elopement requirements.—Facilities are required
1877 to conduct a minimum of two resident elopement prevention and
1878 response drills per year. All administrators and direct care
1879 staff must participate in the drills which shall include a
1880 review of procedures to address resident elopement. Facilities
1881 must document the implementation of the drills and ensure that
1882 the drills are conducted in a manner consistent with the
1883 facility’s resident elopement policies and procedures.
1884 (d) All sanitary conditions within the facility and its
1885 surroundings which will ensure the health and comfort of
1886 residents. To ensure that inspections are not duplicative, the
1887 rules must clearly delineate the responsibilities of the agency
1888 regarding agency’s licensure and survey inspections staff, the
1889 county health departments regarding food safety and sanitary
1890 inspections, and the local fire marshal regarding firesafety
1891 inspections authority having jurisdiction over firesafety and
1892 ensure that inspections are not duplicative. The agency may
1893 collect fees for food service inspections conducted by the
1894 county health departments and transfer such fees to the
1895 Department of Health.
1896 (h) The care and maintenance of residents, which must
1897 include, but is not limited to:
1898 1. The supervision of residents;
1899 2. The provision of personal services;
1900 3. The provision of, or arrangement for, social and leisure
1901 activities;
1902 4. The arrangement for appointments and transportation to
1903 appropriate medical, dental, nursing, or mental health services,
1904 as needed by residents;
1905 5. The management of medication;
1906 6. The food service nutritional needs of residents; and
1907 7. Resident records.; and
1908 8. Internal risk management and quality assurance.
1909 (i) Facilities holding an a limited nursing, extended
1910 congregate care, or limited mental health license.
1911 (j) The establishment of specific criteria to define
1912 appropriateness of resident admission and continued residency in
1913 a facility holding a standard, limited nursing, extended
1914 congregate care, and limited mental health license.
1915 (l) The establishment of specific policies and procedures
1916 on resident elopement. Facilities shall conduct a minimum of two
1917 resident elopement drills each year. All administrators and
1918 direct care staff shall participate in the drills. Facilities
1919 shall document the drills.
1920 (5) Beginning January 1, 2012, the agency shall may use an
1921 abbreviated biennial standard licensure inspection that consists
1922 of a review of key quality-of-care standards in lieu of a full
1923 inspection in a facility that has a good record of past
1924 performance. However, a full inspection must be conducted in a
1925 facility that has a history of class I or class II violations,
1926 uncorrected class III violations, confirmed ombudsman council
1927 complaints, or confirmed licensure complaints, within the
1928 previous licensure period immediately preceding the inspection
1929 or if a potentially serious problem is identified during the
1930 abbreviated inspection. The agency, in consultation with the
1931 department, shall develop, maintain, and update the key quality
1932 of-care standards with input from the State Long-Term Care
1933 Ombudsman Council and representatives of associations and
1934 organizations representing assisted living facilities provider
1935 groups for incorporation into its rules.
1936 Section 25. Section 429.42, Florida Statutes, is amended to
1937 read:
1938 429.42 Pharmacy and dietary services.—
1939 (1) Any assisted living facility in which the agency has
1940 documented a class I or class II violation deficiency or
1941 uncorrected class III violations deficiencies regarding
1942 medicinal drugs or over-the-counter preparations, including
1943 their storage, use, delivery, or administration, or dietary
1944 services, or both, during a biennial survey or a monitoring
1945 visit or an investigation in response to a complaint, shall, in
1946 addition to or as an alternative to any penalties imposed under
1947 s. 429.19, be required to employ the consultant services of a
1948 licensed pharmacist, a licensed registered nurse, or a
1949 registered or licensed dietitian, as applicable. The consultant
1950 shall, at a minimum, provide onsite quarterly consultation until
1951 the inspection team from the agency determines that such
1952 consultation services are no longer required.
1953 (2) A corrective action plan for deficiencies related to
1954 assistance with the self-administration of medication or the
1955 administration of medication must be developed and implemented
1956 by the facility within 48 hours after notification of such
1957 deficiency, or sooner if the deficiency is determined by the
1958 agency to be life-threatening.
1959 (3) The agency shall employ at least two pharmacists
1960 licensed pursuant to chapter 465 among its personnel who
1961 biennially inspect assisted living facilities licensed under
1962 this part, to participate in biennial inspections or consult
1963 with the agency regarding deficiencies relating to medicinal
1964 drugs or over-the-counter preparations.
1965 (2)(4) The department may by rule establish procedures and
1966 specify documentation as necessary to implement this section.
1967 Section 26. Section 429.445, Florida Statutes, is amended
1968 to read:
1969 429.445 Compliance with local zoning requirements.—No
1970 facility licensed under this part may commence any construction
1971 which will expand the size of the existing structure unless the
1972 licensee first submits to the agency proof that such
1973 construction will be in compliance with applicable local zoning
1974 requirements. Facilities with a licensed capacity of less than
1975 15 persons shall comply with the provisions of chapter 419.
1976 Section 27. Section 429.47, Florida Statutes, is amended to
1977 read:
1978 429.47 Prohibited acts; penalties for violation.—
1979 (1) While an assisted living a facility is under
1980 construction or is seeking licensure, the owner may advertise to
1981 the public prior to obtaining a license. Facilities that are
1982 certified under chapter 651 shall comply with the advertising
1983 provisions of s. 651.095 rather than those provided for in this
1984 subsection.
1985 (2) A freestanding facility shall not advertise or imply
1986 that any part of it is a nursing home. For the purpose of this
1987 subsection, “freestanding facility” means a facility that is not
1988 operated in conjunction with a nursing home to which residents
1989 of the facility are given priority when nursing care is
1990 required. A person who violates this subsection is subject to
1991 fine as specified in s. 429.19.
1992 (2)(3) Any facility that which is affiliated with any
1993 religious organization or which has a name implying religious
1994 affiliation shall include in its advertising whether or not it
1995 is affiliated with any religious organization and, if so, which
1996 organization.
1997 (3)(4) A facility licensed under this part which is not
1998 part of a facility authorized under chapter 651 shall include
1999 the facility’s license number as given by the agency in all
2000 advertising. A company or person owning more than one facility
2001 shall include at least one license number per advertisement. All
2002 advertising shall include the term “assisted living facility” or
2003 the abbreviation “ALF” before the license number.
2004 Section 28. Subsection (1) of section 429.49, Florida
2005 Statutes, is amended to read:
2006 429.49 Resident records; penalties for alteration.—
2007 (1) Any person who fraudulently alters, defaces, or
2008 falsifies any medical record or any resident’s other record of
2009 an assisted living facility, or causes or procures any such
2010 offense to be committed, commits a misdemeanor of the second
2011 degree, punishable as provided in s. 775.082 or s. 775.083.
2012 Section 29. Subsections (3), (5), and (8) of section
2013 429.52, Florida Statutes, are amended, present subsection (11)
2014 of that section is redesignated as subsection (12), and a new
2015 subsection (11) is added to that section, read:
2016 429.52 Staff training and educational programs; core
2017 educational requirement.—
2018 (3) Effective January 1, 2004, a new facility administrator
2019 must complete the required training and education, including the
2020 competency test, within a reasonable time after being employed
2021 as an administrator, as determined by the department. Failure to
2022 do so is a violation of this part and subjects the violator to
2023 an administrative fine as prescribed in s. 429.19.
2024 Administrators licensed in accordance with part II of chapter
2025 468 are exempt from this requirement. Other licensed
2026 professionals may be exempted, as determined by the department
2027 by rule.
2028 (5) Staff involved with the management of medications and
2029 assisting with the self-administration of medications under s.
2030 429.256 must complete a minimum of 4 additional hours of
2031 training provided by a registered nurse, licensed pharmacist, or
2032 department staff and must complete 2 hours of continuing
2033 education training annually. The department shall establish by
2034 rule the minimum requirements of this additional training.
2035 (8) The department shall adopt rules related to these
2036 training requirements, the competency test, necessary
2037 procedures, and competency test fees and shall adopt or contract
2038 with another entity to develop a curriculum, which shall be used
2039 as the minimum core training requirements. The department shall
2040 consult with representatives of stakeholder associations,
2041 organizations representing assisted living facilities, and
2042 agencies in the development of the curriculum.
2043 (11) A training provider certified by the department must
2044 continue to meet continuing education requirements and other
2045 standards as set forth in rules adopted by the department. A
2046 training provider or trainee may be sanctioned pursuant to s.
2047 430.081 for failing to comply with the standards set forth in
2048 the rules.
2049 Section 30. Subsections (1) and (2) of section 429.53,
2050 Florida Statutes, are amended to read:
2051 429.53 Consultation by the agency.—
2052 (1) The area offices of licensure and certification of the
2053 agency shall provide consultation to the following upon request:
2054 (a) A licensee of a facility.
2055 (b) A person interested in obtaining a license to operate a
2056 facility under this part.
2057 (2) As used in this section, “consultation” includes:
2058 (a) An explanation of the requirements of this part and
2059 rules adopted pursuant thereto;
2060 (b) An explanation of the license application and renewal
2061 procedures; and
2062 (c) The provision of a checklist of general local and state
2063 approvals required prior to constructing or developing a
2064 facility and a listing of the types of agencies responsible for
2065 such approvals;
2066 (d) An explanation of benefits and financial assistance
2067 available to a recipient of supplemental security income
2068 residing in a facility;
2069 (c)(e) Any other information which the agency deems
2070 necessary to promote compliance with the requirements of this
2071 part.; and
2072 (f) A preconstruction review of a facility to ensure
2073 compliance with agency rules and this part.
2074 Section 31. Section 429.54, Florida Statutes, is repealed.
2075 Section 32. Paragraph (a) of subsection (1) and subsections
2076 (5) and (6) of section 429.71, Florida Statutes, are amended to
2077 read:
2078 429.71 Classification of deficiencies; administrative
2079 fines.—
2080 (1) In addition to the requirements of part II of chapter
2081 408 and in addition to any other liability or penalty provided
2082 by law, the agency may impose an administrative fine on a
2083 provider according to the following classification:
2084 (a) Class I violations are those conditions or practices
2085 related to the operation and maintenance of an adult family-care
2086 home or to the care of residents which the agency determines
2087 present an imminent danger to the residents or guests of the
2088 adult family-care home facility or a substantial probability
2089 that death or serious physical or emotional harm would result
2090 therefrom. The condition or practice that constitutes a class I
2091 violation must be abated or eliminated within 24 hours, unless a
2092 fixed period, as determined by the agency, is required for
2093 correction. A class I violation deficiency is subject to an
2094 administrative fine in an amount not less than $500 and not
2095 exceeding $1,000 for each violation. A fine may be levied
2096 notwithstanding the correction of the violation deficiency.
2097 (5) As an alternative to or in conjunction with an
2098 administrative action against a provider, the agency may request
2099 a plan of corrective action that demonstrates a good faith
2100 effort to remedy each violation by a specific date, subject to
2101 the approval of the agency.
2102 (5)(6) The department shall set forth, by rule, notice
2103 requirements and procedures for correction of violations
2104 deficiencies.
2105 Section 33. Subsection (3) is added to section 429.81,
2106 Florida Statutes, to read:
2107 429.81 Residency agreements.—
2108 (3) Each residency agreement must specify that the resident
2109 must give the provider a 30 days’ written notice of intent to
2110 terminate his or her residency from the adult family-care home.
2111 Section 34. Section 430.081, Florida Statutes, is created
2112 to read:
2113 430.081 Sanctioning of training providers and trainees.—The
2114 Department of Elderly Affairs may sanction training providers
2115 and trainees for infractions involving any required training
2116 that the department has the authority to regulate under chapter
2117 400, chapter 429, or chapter 430 in order to ensure that such
2118 training providers and trainees satisfy specific qualification
2119 requirements and adhere to training curricula that is approved
2120 by the department. Training infractions include, but are not
2121 limited to, falsification of training records, falsification of
2122 training certificates, falsification of a training provider’s
2123 qualifications, failure to adhere to the required number of
2124 training hours, failure to use the required curriculum, failure
2125 to maintain the continuing education for the training provider’s
2126 recertification, failure to obtain reapproval of a curriculum
2127 when required, providing false or inaccurate information,
2128 misrepresentation of the required materials, and use of a false
2129 identification as a training provider or trainee. Sanctions may
2130 be progressive in nature and may consist of corrective action
2131 measures; suspension or termination from participation as an
2132 approved training provider or trainee, including sitting for any
2133 required examination; and administrative fines not to exceed
2134 $1,000 per incident. One or more sanctions may be levied per
2135 incident.
2136 Section 35. Paragraph (j) is added to subsection (3) of
2137 section 817.505, Florida Statutes, to read:
2138 817.505 Patient brokering prohibited; exceptions;
2139 penalties.—
2140 (3) This section shall not apply to:
2141 (j) Any payments by an assisted living facility, as defined
2142 in s. 429.02, which are permitted under s. 429.195(3).
2143 Section 36. Licensure fees adjusted by consumer price index
2144 increases prior to the effective date of this act are not
2145 intended to be reset by this act and may continue to accrue as
2146 authorized by law.
2147 Section 37. This act shall take effect July 1, 2011.