Florida Senate - 2012 SB 1332
By Senator Fasano
11-00310D-12 20121332__
1 A bill to be entitled
2 An act relating to staffing requirements for nursing
3 home facilities; amending s. 400.23, F.S.; revising
4 the Agency for Health Care Administration’s rulemaking
5 authority relating to minimum staffing requirements
6 for nursing home facilities; amending s. 400.141,
7 F.S.; conforming a cross-reference; providing an
8 appropriation; providing an effective date.
9
10 Be It Enacted by the Legislature of the State of Florida:
11
12 Section 1. Paragraph (a) of subsection (3) of section
13 400.23, Florida Statutes, is amended to read:
14 400.23 Rules; evaluation and deficiencies; licensure
15 status.—
16 (3)(a)1. The agency shall adopt rules providing minimum
17 staffing requirements for nursing home facilities. These
18 requirements must include, for each facility:
19 a. A minimum weekly average of certified nursing assistant
20 and licensed nursing staffing combined of 3.6 hours of direct
21 care per resident per day. As used in this sub-subparagraph, a
22 week is defined as Sunday through Saturday.
23 a.b. A minimum certified nursing assistant staffing of 2.9
24 2.5 hours of direct care per resident per day. A facility may
25 not staff below one certified nursing assistant per 20
26 residents.
27 b.c. A minimum licensed nursing staffing of 1.0 hour of
28 direct care per resident per day. A facility may not staff below
29 one licensed nurse per 40 residents.
30 2. Nursing assistants employed under s. 400.211(2) may be
31 included in computing the staffing ratio for certified nursing
32 assistants if their job responsibilities include only nursing
33 assistant-related duties.
34 3. Each nursing home facility must document compliance with
35 staffing standards as required under this paragraph and post
36 daily the names of staff on duty for the benefit of facility
37 residents and the public.
38 4. The agency shall recognize the use of licensed nurses
39 for compliance with minimum staffing requirements for certified
40 nursing assistants if the nursing home facility otherwise meets
41 the minimum staffing requirements for licensed nurses and the
42 licensed nurses are performing the duties of a certified nursing
43 assistant. Unless otherwise approved by the agency, licensed
44 nurses counted toward the minimum staffing requirements for
45 certified nursing assistants must exclusively perform the duties
46 of a certified nursing assistant for the entire shift and not
47 also be counted toward the minimum staffing requirements for
48 licensed nurses. If the agency approved a facility’s request to
49 use a licensed nurse to perform both licensed nursing and
50 certified nursing assistant duties, the facility must allocate
51 the amount of staff time specifically spent on certified nursing
52 assistant duties for the purpose of documenting compliance with
53 minimum staffing requirements for certified and licensed nursing
54 staff. The hours of a licensed nurse who has with dual job
55 responsibilities may not be counted twice.
56 Section 2. Paragraph (o) of subsection (1) of section
57 400.141, Florida Statutes, is amended to read:
58 400.141 Administration and management of nursing home
59 facilities.—
60 (1) Every licensed facility shall comply with all
61 applicable standards and rules of the agency and shall:
62 (o)1. Submit semiannually to the agency, or more frequently
63 if requested by the agency, information regarding facility
64 staff-to-resident ratios, staff turnover, and staff stability,
65 including information regarding certified nursing assistants,
66 licensed nurses, the director of nursing, and the facility
67 administrator. For purposes of this reporting:
68 a. Staff-to-resident ratios must be reported in the
69 categories specified in s. 400.23(3)(a) and applicable rules.
70 The ratio must be reported as an average for the most recent
71 calendar quarter.
72 b. Staff turnover must be reported for the most recent 12
73 month period ending on the last workday of the most recent
74 calendar quarter prior to the date the information is submitted.
75 The turnover rate must be computed quarterly, with the annual
76 rate being the cumulative sum of the quarterly rates. The
77 turnover rate is the total number of terminations or separations
78 experienced during the quarter, excluding any employee
79 terminated during a probationary period of 3 months or less,
80 divided by the total number of staff employed at the end of the
81 period for which the rate is computed, and expressed as a
82 percentage.
83 c. The formula for determining staff stability is the total
84 number of employees that have been employed for more than 12
85 months, divided by the total number of employees employed at the
86 end of the most recent calendar quarter, and expressed as a
87 percentage.
88 d. A nursing facility that has failed to comply with state
89 minimum-staffing requirements for 2 consecutive days is
90 prohibited from accepting new admissions until the facility has
91 achieved the minimum-staffing requirements for a period of 6
92 consecutive days. For the purposes of this sub-subparagraph, any
93 person who was a resident of the facility and was absent from
94 the facility for the purpose of receiving medical care at a
95 separate location or was on a leave of absence is not considered
96 a new admission. Failure to impose such an admissions moratorium
97 constitutes a class II deficiency.
98 e. A nursing facility that which does not have a
99 conditional license may be cited for failure to comply with the
100 standards in s. 400.23(3)(a)1.a. and b. 400.23(3)(a)1.b. and c.
101 only if it has failed to meet those standards on 2 consecutive
102 days or if it has failed to meet at least 97 percent of those
103 standards on any one day.
104 f. A facility that which has a conditional license must be
105 in compliance with the standards in s. 400.23(3)(a) at all
106 times.
107 2. This paragraph does not limit the agency’s ability to
108 impose a deficiency or take other actions if a facility does not
109 have enough staff to meet the residents’ needs.
110 Section 3. For the 2011-2012 fiscal year, the sum of $40
111 million is appropriated in recurring funds from the General
112 Revenue Fund to the Agency for Health Care Administration for
113 the purpose of providing, maintaining, and improving staffing
114 requirements for nursing home facilities as provided in this
115 act.
116 Section 4. This act shall take effect upon becoming a law.