Florida Senate - 2020 PROPOSED COMMITTEE SUBSTITUTE
Bill No. CS for SB 402
Ì831164ÂÎ831164
576-03911-20
Proposed Committee Substitute by the Committee on Appropriations
(Appropriations Subcommittee on Health and Human Services)
1 A bill to be entitled
2 An act relating to assisted living facilities;
3 amending s. 429.02, F.S.; defining and revising terms;
4 amending s. 429.07, F.S.; requiring assisted living
5 facilities that provide certain services to maintain a
6 written progress report on each person receiving
7 services from the facility’s staff; conforming a
8 cross-reference; amending s. 429.11, F.S.; prohibiting
9 a county or municipality from issuing a business tax
10 receipt, rather than an occupational license, to a
11 facility under certain circumstances; amending s.
12 429.176, F.S.; requiring an owner of a facility to
13 provide certain documentation to the Agency for Health
14 Care Administration within a specified timeframe;
15 amending s. 429.23, F.S.; authorizing a facility to
16 send certain reports regarding adverse incidents
17 through the agency’s online portal; requiring the
18 agency to send reminders by electronic mail to certain
19 facility contacts regarding submission deadlines for
20 such reports within a specified timeframe; amending s.
21 429.255, F.S.; authorizing certain persons to change a
22 resident’s bandage for a minor cut or abrasion;
23 authorizing certain persons to contract with a third
24 party to provide services to a resident under certain
25 circumstances; providing requirements relating to the
26 third-party provider; clarifying that the absence of
27 an order not to resuscitate does not preclude a
28 physician from withholding or withdrawing
29 cardiopulmonary resuscitation or use of an automated
30 external defibrillator; amending s. 429.256, F.S.;
31 revising the types of medications that may be self
32 administered; revising provisions relating to
33 assistance with the self-administration of such
34 medications; requiring a person assisting with a
35 resident’s self-administration of medication to
36 confirm and advise the patient of specified
37 information; authorizing a resident to opt out of such
38 advisement through a signed waiver; providing
39 requirements for such waiver; revising provisions
40 relating to certain medications that are not self
41 administered with assistance; amending s. 429.26,
42 F.S.; including medical examinations in the criteria
43 used for admission to an assisted living facility;
44 providing specified criteria for determination of
45 appropriateness for admission to and continued
46 residency in an assisted living facility; prohibiting
47 such facility from admitting certain individuals;
48 defining the term “bedridden”; authorizing a facility
49 to retain certain individuals under certain
50 conditions; requiring that a resident receive a
51 medical examination within a specified timeframe after
52 admission to a facility; requiring that such
53 examination be recorded on a form; providing
54 limitations on the use of such form; providing
55 requirements for the content of the form; revising
56 provisions relating to the placement of residents by
57 the Department of Children and Families; requiring a
58 facility to notify a resident’s representative or
59 designee of specified information under certain
60 circumstances; requiring the facility to arrange with
61 an appropriate health care provider for the care and
62 services needed to treat a resident under certain
63 circumstances; removing provisions relating to the
64 retention of certain residents in a facility; amending
65 s. 429.28, F.S.; requiring facilities to provide
66 written notice of relocation or termination of
67 residency from a facility to the resident or the
68 resident’s legal guardian; revising provisions related
69 to a licensure survey required by the agency; deleting
70 a requirement that the agency adopt certain rules;
71 amending s. 429.31, F.S.; revising notice requirements
72 for facilities that are terminating operations;
73 requiring the agency to inform the State Long-Term
74 Ombudsman Program immediately upon notice of a
75 facility’s termination of operations; amending s.
76 429.41, F.S.; revising legislative intent; revising
77 provisions related to rules the agency, in
78 consultation with the Department of Children and
79 Families and the Department of Health, is required to
80 adopt regarding minimum standards of resident care;
81 requiring county emergency management agencies, rather
82 than local emergency management agencies, to review
83 and approve or disapprove of a facility’s
84 comprehensive emergency management plan; requiring a
85 facility to submit a comprehensive emergency
86 management plan to the county emergency management
87 agency within a specified timeframe; prohibiting the
88 use of Posey restraints; authorizing the use of other
89 restraints under certain circumstances; revising the
90 criteria under which a facility must be fully
91 inspected; creating s. 429.435, F.S.; requiring the
92 State Fire Marshall to establish uniform firesafety
93 standards for assisted living facilities; providing
94 for a firesafety evacuation capability determination
95 within a specified timeframe under certain
96 circumstances; requiring the State Fire Marshall to
97 use certain standards from a specified national
98 association to determine the uniform firesafety
99 standards to be adopted; authorizing local governments
100 and utilities to charge certain fees relating to fire
101 sprinkler systems; requiring licensed facilities to
102 have an annual fire inspection; specifying certain
103 code requirements for facilities that undergo a
104 specific alteration or rehabilitation; amending s.
105 429.52, F.S.; revising certain provisions relating to
106 facility staff training and educational requirements;
107 requiring the agency, in conjunction with providers,
108 to establish core training requirements for facility
109 administrators; revising the training and continuing
110 education requirements for facility staff who assist
111 residents with the self-administration of medications;
112 revising provisions relating to the training
113 responsibilities of the agency; requiring the agency
114 to contract with another entity to administer a
115 certain competency test; requiring the agency to adopt
116 a curriculum outline with learning objectives to be
117 used by core trainers; conforming provisions to
118 changes made by the act; providing an effective date.
119
120 Be It Enacted by the Legislature of the State of Florida:
121
122 Section 1. Present subsections (7) through (27) of section
123 429.02, Florida Statutes, are redesignated as subsections (8)
124 through (28), respectively, a new subsection (7) is added to
125 that section, and present subsections (11) and (18) are amended,
126 to read:
127 429.02 Definitions.—When used in this part, the term:
128 (7) “Assistive device” means any device designed or adapted
129 to help a resident perform an action, a task, an activity of
130 daily living, or a transfer; prevent a fall; or recover from a
131 fall. The term does not include a total body lift or a motorized
132 sit-to-stand lift, with the exception of a chair lift or
133 recliner lift that a resident is able to operate independently.
134 (12)(11) “Extended congregate care” means acts beyond those
135 authorized in subsection (18) which (17) that may be performed
136 pursuant to part I of chapter 464 by persons licensed thereunder
137 while carrying out their professional duties, and other
138 supportive services that which may be specified by rule. The
139 purpose of such services is to enable residents to age in place
140 in a residential environment despite mental or physical
141 limitations that might otherwise disqualify them from residency
142 in a facility licensed under this part.
143 (19)(18) “Physical restraint” means a device that which
144 physically limits, restricts, or deprives an individual of
145 movement or mobility, including, but not limited to, a half-bed
146 rail, a full-bed rail, a geriatric chair, and a posey restraint.
147 The term “physical restraint” shall also include any device that
148 is which was not specifically manufactured as a restraint but is
149 which has been altered, arranged, or otherwise used for that
150 this purpose. The term does shall not include any device that
151 the resident chooses to use and is able to remove or avoid
152 independently, or any bandage material used for the purpose of
153 binding a wound or injury.
154 Section 2. Paragraphs (b) and (c) of subsection (3) of
155 section 429.07, Florida Statutes, are amended to read:
156 429.07 License required; fee.—
157 (3) In addition to the requirements of s. 408.806, each
158 license granted by the agency must state the type of care for
159 which the license is granted. Licenses shall be issued for one
160 or more of the following categories of care: standard, extended
161 congregate care, limited nursing services, or limited mental
162 health.
163 (b) An extended congregate care license shall be issued to
164 each facility that has been licensed as an assisted living
165 facility for 2 or more years and that provides services,
166 directly or through contract, beyond those authorized in
167 paragraph (a), including services performed by persons licensed
168 under part I of chapter 464 and supportive services, as defined
169 by rule, to persons who would otherwise be disqualified from
170 continued residence in a facility licensed under this part. An
171 extended congregate care license may be issued to a facility
172 that has a provisional extended congregate care license and
173 meets the requirements for licensure under subparagraph 2. The
174 primary purpose of extended congregate care services is to allow
175 residents the option of remaining in a familiar setting from
176 which they would otherwise be disqualified for continued
177 residency as they become more impaired. A facility licensed to
178 provide extended congregate care services may also admit an
179 individual who exceeds the admission criteria for a facility
180 with a standard license, if he or she is determined appropriate
181 for admission to the extended congregate care facility.
182 1. In order for extended congregate care services to be
183 provided, the agency must first determine that all requirements
184 established in law and rule are met and must specifically
185 designate, on the facility’s license, that such services may be
186 provided and whether the designation applies to all or part of
187 the facility. This designation may be made at the time of
188 initial licensure or relicensure, or upon request in writing by
189 a licensee under this part and part II of chapter 408. The
190 notification of approval or the denial of the request shall be
191 made in accordance with part II of chapter 408. Each existing
192 facility that qualifies to provide extended congregate care
193 services must have maintained a standard license and may not
194 have been subject to administrative sanctions during the
195 previous 2 years, or since initial licensure if the facility has
196 been licensed for less than 2 years, for any of the following
197 reasons:
198 a. A class I or class II violation;
199 b. Three or more repeat or recurring class III violations
200 of identical or similar resident care standards from which a
201 pattern of noncompliance is found by the agency;
202 c. Three or more class III violations that were not
203 corrected in accordance with the corrective action plan approved
204 by the agency;
205 d. Violation of resident care standards which results in
206 requiring the facility to employ the services of a consultant
207 pharmacist or consultant dietitian;
208 e. Denial, suspension, or revocation of a license for
209 another facility licensed under this part in which the applicant
210 for an extended congregate care license has at least 25 percent
211 ownership interest; or
212 f. Imposition of a moratorium pursuant to this part or part
213 II of chapter 408 or initiation of injunctive proceedings.
214
215 The agency may deny or revoke a facility’s extended congregate
216 care license for not meeting the criteria for an extended
217 congregate care license as provided in this subparagraph.
218 2. If an assisted living facility has been licensed for
219 less than 2 years, the initial extended congregate care license
220 must be provisional and may not exceed 6 months. The licensee
221 shall notify the agency, in writing, when it has admitted at
222 least one extended congregate care resident, after which an
223 unannounced inspection shall be made to determine compliance
224 with the requirements of an extended congregate care license. A
225 licensee with a provisional extended congregate care license
226 which that demonstrates compliance with all the requirements of
227 an extended congregate care license during the inspection shall
228 be issued an extended congregate care license. In addition to
229 sanctions authorized under this part, if violations are found
230 during the inspection and the licensee fails to demonstrate
231 compliance with all assisted living facility requirements during
232 a followup inspection, the licensee shall immediately suspend
233 extended congregate care services, and the provisional extended
234 congregate care license expires. The agency may extend the
235 provisional license for not more than 1 month in order to
236 complete a followup visit.
237 3. A facility that is licensed to provide extended
238 congregate care services shall maintain a written progress
239 report on each person who receives nursing services from the
240 facility’s staff which describes the type, amount, duration,
241 scope, and outcome of services that are rendered and the general
242 status of the resident’s health. A registered nurse, or
243 appropriate designee, representing the agency shall visit the
244 facility at least twice a year to monitor residents who are
245 receiving extended congregate care services and to determine if
246 the facility is in compliance with this part, part II of chapter
247 408, and relevant rules. One of the visits may be in conjunction
248 with the regular survey. The monitoring visits may be provided
249 through contractual arrangements with appropriate community
250 agencies. A registered nurse shall serve as part of the team
251 that inspects the facility. The agency may waive one of the
252 required yearly monitoring visits for a facility that has:
253 a. Held an extended congregate care license for at least 24
254 months;
255 b. No class I or class II violations and no uncorrected
256 class III violations; and
257 c. No ombudsman council complaints that resulted in a
258 citation for licensure.
259 4. A facility that is licensed to provide extended
260 congregate care services must:
261 a. Demonstrate the capability to meet unanticipated
262 resident service needs.
263 b. Offer a physical environment that promotes a homelike
264 setting, provides for resident privacy, promotes resident
265 independence, and allows sufficient congregate space as defined
266 by rule.
267 c. Have sufficient staff available, taking into account the
268 physical plant and firesafety features of the building, to
269 assist with the evacuation of residents in an emergency.
270 d. Adopt and follow policies and procedures that maximize
271 resident independence, dignity, choice, and decisionmaking to
272 permit residents to age in place, so that moves due to changes
273 in functional status are minimized or avoided.
274 e. Allow residents or, if applicable, a resident’s
275 representative, designee, surrogate, guardian, or attorney in
276 fact to make a variety of personal choices, participate in
277 developing service plans, and share responsibility in
278 decisionmaking.
279 f. Implement the concept of managed risk.
280 g. Provide, directly or through contract, the services of a
281 person licensed under part I of chapter 464.
282 h. In addition to the training mandated in s. 429.52,
283 provide specialized training as defined by rule for facility
284 staff.
285 5. A facility that is licensed to provide extended
286 congregate care services is exempt from the criteria for
287 continued residency set forth in rules adopted under s. 429.41.
288 A licensed facility must adopt its own requirements within
289 guidelines for continued residency set forth by rule. However,
290 the facility may not serve residents who require 24-hour nursing
291 supervision. A licensed facility that provides extended
292 congregate care services must also provide each resident with a
293 written copy of facility policies governing admission and
294 retention.
295 6. Before the admission of an individual to a facility
296 licensed to provide extended congregate care services, the
297 individual must undergo a medical examination as provided in s.
298 429.26(5) s. 429.26(4) and the facility must develop a
299 preliminary service plan for the individual.
300 7. If a facility can no longer provide or arrange for
301 services in accordance with the resident’s service plan and
302 needs and the facility’s policy, the facility must make
303 arrangements for relocating the person in accordance with s.
304 429.28(1)(k).
305 (c) A limited nursing services license shall be issued to a
306 facility that provides services beyond those authorized in
307 paragraph (a) and as specified in this paragraph.
308 1. In order for limited nursing services to be provided in
309 a facility licensed under this part, the agency must first
310 determine that all requirements established in law and rule are
311 met and must specifically designate, on the facility’s license,
312 that such services may be provided. This designation may be made
313 at the time of initial licensure or licensure renewal, or upon
314 request in writing by a licensee under this part and part II of
315 chapter 408. Notification of approval or denial of such request
316 shall be made in accordance with part II of chapter 408. An
317 existing facility that qualifies to provide limited nursing
318 services must have maintained a standard license and may not
319 have been subject to administrative sanctions that affect the
320 health, safety, and welfare of residents for the previous 2
321 years or since initial licensure if the facility has been
322 licensed for less than 2 years.
323 2. A facility that is licensed to provide limited nursing
324 services shall maintain a written progress report on each person
325 who receives such nursing services from the facility’s staff.
326 The report must describe the type, amount, duration, scope, and
327 outcome of services that are rendered and the general status of
328 the resident’s health. A registered nurse representing the
329 agency shall visit the facility at least annually to monitor
330 residents who are receiving limited nursing services and to
331 determine if the facility is in compliance with applicable
332 provisions of this part, part II of chapter 408, and related
333 rules. The monitoring visits may be provided through contractual
334 arrangements with appropriate community agencies. A registered
335 nurse shall also serve as part of the team that inspects such
336 facility. Visits may be in conjunction with other agency
337 inspections. The agency may waive the required yearly monitoring
338 visit for a facility that has:
339 a. Had a limited nursing services license for at least 24
340 months;
341 b. No class I or class II violations and no uncorrected
342 class III violations; and
343 c. No ombudsman council complaints that resulted in a
344 citation for licensure.
345 3. A person who receives limited nursing services under
346 this part must meet the admission criteria established by the
347 agency for assisted living facilities. When a resident no longer
348 meets the admission criteria for a facility licensed under this
349 part, arrangements for relocating the person shall be made in
350 accordance with s. 429.28(1)(k), unless the facility is licensed
351 to provide extended congregate care services.
352 Section 3. Subsection (7) of section 429.11, Florida
353 Statutes, is amended to read:
354 429.11 Initial application for license; provisional
355 license.—
356 (7) A county or municipality may not issue a business tax
357 receipt an occupational license that is being obtained for the
358 purpose of operating a facility regulated under this part
359 without first ascertaining that the applicant has been licensed
360 to operate such facility at the specified location or locations
361 by the agency. The agency shall furnish to local agencies
362 responsible for issuing business tax receipts occupational
363 licenses sufficient instruction for making such determinations.
364 Section 4. Section 429.176, Florida Statutes, is amended to
365 read:
366 429.176 Notice of change of administrator.—If, during the
367 period for which a license is issued, the owner changes
368 administrators, the owner must notify the agency of the change
369 within 10 days and provide documentation within 90 days that the
370 new administrator meets educational requirements and has
371 completed the applicable core educational requirements under s.
372 429.52. A facility may not be operated for more than 120
373 consecutive days without an administrator who has completed the
374 core educational requirements.
375 Section 5. Subsections (3), (4), and (5) of section 429.23,
376 Florida Statutes, are amended to read:
377 429.23 Internal risk management and quality assurance
378 program; adverse incidents and reporting requirements.—
379 (3) Licensed facilities shall provide within 1 business day
380 after the occurrence of an adverse incident, through the
381 agency’s online portal or, if the portal is offline, by
382 electronic mail, facsimile, or United States mail, a preliminary
383 report to the agency on all adverse incidents specified under
384 this section. The report must include information regarding the
385 identity of the affected resident, the type of adverse incident,
386 and the status of the facility’s investigation of the incident.
387 (4) Licensed facilities shall provide within 15 days,
388 through the agency’s online portal or, if the portal is offline,
389 by electronic mail, facsimile, or United States mail, a full
390 report to the agency on all adverse incidents specified in this
391 section. The report must include the results of the facility’s
392 investigation into the adverse incident.
393 (5) Three business days before the deadline for the
394 submission of the full report required under subsection (4), the
395 agency shall send by electronic mail a reminder to the
396 facility’s administrator and other specified facility contacts.
397 Within 3 business days after the agency sends the reminder, a
398 facility is not subject to any administrative or other agency
399 action for failing to withdraw the preliminary report if the
400 facility determines the event was not an adverse incident or for
401 failing to file a full report if the facility determines the
402 event was an adverse incident Each facility shall report monthly
403 to the agency any liability claim filed against it. The report
404 must include the name of the resident, the dates of the incident
405 leading to the claim, if applicable, and the type of injury or
406 violation of rights alleged to have occurred. This report is not
407 discoverable in any civil or administrative action, except in
408 such actions brought by the agency to enforce the provisions of
409 this part.
410 Section 6. Paragraphs (a) and (b) of subsection (1) of
411 section 429.255, Florida Statutes, are amended, paragraph (d) is
412 added to that subsection, and subsection (4) of that section is
413 amended, to read:
414 429.255 Use of personnel; emergency care.—
415 (1)(a) Persons under contract to the facility, facility
416 staff, or volunteers, who are licensed according to part I of
417 chapter 464, or those persons exempt under s. 464.022(1), and
418 others as defined by rule, may administer medications to
419 residents, take residents’ vital signs, change residents’
420 bandages for minor cuts and abrasions, manage individual weekly
421 pill organizers for residents who self-administer medication,
422 give prepackaged enemas ordered by a physician, observe
423 residents, document observations on the appropriate resident’s
424 record, and report observations to the resident’s physician, and
425 contract or allow residents or a resident’s representative,
426 designee, surrogate, guardian, or attorney in fact to contract
427 with a third party, provided residents meet the criteria for
428 appropriate placement as defined in s. 429.26. Nursing
429 assistants certified pursuant to part II of chapter 464 may take
430 residents’ vital signs as directed by a licensed nurse or
431 physician.
432 (b) All staff of in facilities licensed under this part
433 shall exercise their professional responsibility to observe
434 residents, to document observations on the appropriate
435 resident’s record, and to report the observations to the
436 resident’s physician. However, the owner or administrator of the
437 facility shall be responsible for determining that the resident
438 receiving services is appropriate for residence in the facility.
439 (d) A resident or his or her representative, designee,
440 surrogate, guardian, or attorney in fact, as applicable, may
441 contract for services with a third party, provided the resident
442 meets the criteria for residency and continued residency as
443 defined in s. 429.26. The third party must communicate with the
444 facility regarding the resident’s condition and the services
445 being provided in accordance with the facility’s policies. The
446 facility must document that it received such communication.
447 (4) Facility staff may withhold or withdraw cardiopulmonary
448 resuscitation or the use of an automated external defibrillator
449 if presented with an order not to resuscitate executed pursuant
450 to s. 401.45. The agency shall adopt rules providing for the
451 implementation of such orders. Facility staff and facilities may
452 not be subject to criminal prosecution or civil liability, nor
453 be considered to have engaged in negligent or unprofessional
454 conduct, for withholding or withdrawing cardiopulmonary
455 resuscitation or use of an automated external defibrillator
456 pursuant to such an order and rules adopted by the agency. The
457 absence of an order not to resuscitate executed pursuant to s.
458 401.45 does not preclude a physician from withholding or
459 withdrawing cardiopulmonary resuscitation or use of an automated
460 external defibrillator as otherwise permitted by law.
461 Section 7. Subsection (2), paragraph (b) of subsection (3),
462 and paragraphs (e), (f), and (g) of subsection (4) of section
463 429.256, Florida Statutes, are amended to read:
464 429.256 Assistance with self-administration of medication.—
465 (2) Residents who are capable of self-administering their
466 own medications without assistance shall be encouraged and
467 allowed to do so. However, an unlicensed person may, consistent
468 with a dispensed prescription’s label or the package directions
469 of an over-the-counter medication, assist a resident whose
470 condition is medically stable with the self-administration of
471 routine, regularly scheduled medications that are intended to be
472 self-administered. Assistance with self-medication by an
473 unlicensed person may occur only upon a documented request by,
474 and the written informed consent of, a resident or the
475 resident’s surrogate, guardian, or attorney in fact. For the
476 purposes of this section, self-administered medications include
477 both legend and over-the-counter oral dosage forms, topical
478 dosage forms, transdermal patches, and topical ophthalmic, otic,
479 and nasal dosage forms including solutions, suspensions, sprays,
480 and inhalers.
481 (3) Assistance with self-administration of medication
482 includes:
483 (b) In the presence of the resident, confirming that the
484 medication is intended for that resident, orally advising the
485 resident of the medication name and dosage reading the label,
486 opening the container, removing a prescribed amount of
487 medication from the container, and closing the container. The
488 resident may sign a written waiver to opt out of being orally
489 advised of the medication name and dosage. The waiver must
490 identify all of the medications intended for the resident,
491 including names and dosages of such medications, and must
492 immediately be updated each time the resident’s medications or
493 dosages change.
494 (4) Assistance with self-administration does not include:
495 (e) The use of irrigations or debriding agents used in the
496 treatment of a skin condition.
497 (f) Assisting with rectal, urethral, or vaginal
498 preparations.
499 (g) Assisting with medications ordered by the physician or
500 health care professional with prescriptive authority to be given
501 “as needed,” unless the order is written with specific
502 parameters that preclude independent judgment on the part of the
503 unlicensed person, and at the request of a competent resident
504 requesting the medication is aware of his or her need for the
505 medication and understands the purpose for taking the
506 medication.
507 Section 8. Section 429.26, Florida Statutes, is amended to
508 read:
509 429.26 Appropriateness of placements; examinations of
510 residents.—
511 (1) The owner or administrator of a facility is responsible
512 for determining the appropriateness of admission of an
513 individual to the facility and for determining the continued
514 appropriateness of residence of an individual in the facility. A
515 determination must shall be based upon an evaluation assessment
516 of the strengths, needs, and preferences of the resident, a
517 medical examination, the care and services offered or arranged
518 for by the facility in accordance with facility policy, and any
519 limitations in law or rule related to admission criteria or
520 continued residency for the type of license held by the facility
521 under this part. The following criteria apply to the
522 determination of appropriateness for admission and continued
523 residency of an individual in a facility:
524 (a) A facility may admit or retain a resident who receives
525 a health care service or treatment that is designed to be
526 provided within a private residential setting if all
527 requirements for providing that service or treatment are met by
528 the facility or a third party.
529 (b) A facility may admit or retain a resident who requires
530 the use of assistive devices.
531 (c) A facility may admit or retain an individual receiving
532 hospice services if the arrangement is agreed to by the facility
533 and the resident, additional care is provided by a licensed
534 hospice, and the resident is under the care of a physician who
535 agrees that the physical needs of the resident can be met at the
536 facility. The resident must have a plan of care which delineates
537 how the facility and the hospice will meet the scheduled and
538 unscheduled needs of the resident, including, if applicable,
539 staffing for nursing care.
540 (d)1. Except for a resident who is receiving hospice
541 services as provided in paragraph (c), a facility may not admit
542 or retain a resident who is bedridden or who requires 24-hour
543 nursing supervision. For purposes of this paragraph, the term
544 “bedridden” means that a resident is confined to a bed because
545 of the inability to:
546 a. Move, turn, or reposition without total physical
547 assistance;
548 b. Transfer to a chair or wheelchair without total physical
549 assistance; or
550 c. Sit safely in a chair or wheelchair without personal
551 assistance or a physical restraint.
552 2. A resident may continue to reside in a facility if,
553 during residency, he or she is bedridden for no more than 7
554 consecutive days.
555 3. If a facility is licensed to provide extended congregate
556 care, a resident may continue to reside in a facility if, during
557 residency, he or she is bedridden for no more than 14
558 consecutive days.
559 (2) A resident may not be moved from one facility to
560 another without consultation with and agreement from the
561 resident or, if applicable, the resident’s representative or
562 designee or the resident’s family, guardian, surrogate, or
563 attorney in fact. In the case of a resident who has been placed
564 by the department or the Department of Children and Families,
565 the administrator must notify the appropriate contact person in
566 the applicable department.
567 (3)(2) A physician, physician assistant, or advanced
568 practice registered nurse practitioner who is employed by an
569 assisted living facility to provide an initial examination for
570 admission purposes may not have financial interests interest in
571 the facility.
572 (4)(3) Persons licensed under part I of chapter 464 who are
573 employed by or under contract with a facility shall, on a
574 routine basis or at least monthly, perform a nursing assessment
575 of the residents for whom they are providing nursing services
576 ordered by a physician, except administration of medication, and
577 shall document such assessment, including any substantial
578 changes in a resident’s status which may necessitate relocation
579 to a nursing home, hospital, or specialized health care
580 facility. Such records shall be maintained in the facility for
581 inspection by the agency and shall be forwarded to the
582 resident’s case manager, if applicable.
583 (5)(a)(4) If possible, Each resident must shall have been
584 examined by a licensed physician, a licensed physician
585 assistant, or a licensed advanced practice registered nurse
586 practitioner within 60 days before admission to the facility or
587 within 30 days after admission to the facility, except as
588 provided in s. 429.07. The information from the medical
589 examination must be recorded on the practitioner’s form or on a
590 form adopted by agency rule. The signed and completed medical
591 examination form, signed only by the practitioner, must report
592 shall be submitted to the owner or administrator of the
593 facility, who shall use the information contained therein to
594 assist in the determination of the appropriateness of the
595 resident’s admission to or and continued residency stay in the
596 facility.
597 (b) The medical examination form may be used only to record
598 the practitioner’s direct observation of the patient at the time
599 of examination and must include the patient’s medical history.
600 Such form does not guarantee admission to, continued residency
601 in, or the delivery of services at the facility and must be used
602 only as an informative tool to assist in the determination of
603 the appropriateness of the resident’s admission to or continued
604 residency in the facility. The medical examination form,
605 reflecting the resident’s condition on the date the examination
606 is performed, becomes report shall become a permanent part of
607 the facility’s record of the resident at the facility and must
608 shall be made available to the agency during inspection or upon
609 request. An assessment that has been completed through the
610 Comprehensive Assessment and Review for Long-Term Care Services
611 (CARES) Program fulfills the requirements for a medical
612 examination under this subsection and s. 429.07(3)(b)6.
613 (c) The medical examination form must include all of the
614 following information about the resident:
615 1. Height, weight, and known allergies.
616 2. Significant medical history and diagnoses.
617 3. Physical or sensory limitations, including the need for
618 fall precautions or recommended use of assistive devices.
619 4. Cognitive or behavioral status and a brief description
620 of any behavioral issues known or ascertained by the examining
621 practitioner, including any known history of wandering or
622 elopement.
623 5. Nursing, treatment, or therapy service requirements.
624 6. Whether the resident needs assistance for ambulating,
625 eating, or transferring.
626 7. Special dietary instructions.
627 8. Whether the resident has any communicable diseases,
628 including precautions that are necessary due to such diseases.
629 9. Whether the resident is bedridden and the presence of
630 any pressure sores.
631 10. Whether the resident needs 24-hour nursing supervision
632 or psychiatric care.
633 11. A list of current prescribed medications as known or
634 ascertained by the examining practitioner and whether the
635 resident can self-administer medications, needs assistance with
636 medications, or needs medication administration.
637 (5) Except as provided in s. 429.07, if a medical
638 examination has not been completed within 60 days before the
639 admission of the resident to the facility, a licensed physician,
640 licensed physician assistant, or licensed nurse practitioner
641 shall examine the resident and complete a medical examination
642 form provided by the agency within 30 days following the
643 admission to the facility to enable the facility owner or
644 administrator to determine the appropriateness of the admission.
645 The medical examination form shall become a permanent part of
646 the record of the resident at the facility and shall be made
647 available to the agency during inspection by the agency or upon
648 request.
649 (6) Any resident accepted in a facility and placed by the
650 department or the Department of Children and Families must shall
651 have been examined by medical personnel within 30 days before
652 placement in the facility. The examination must shall include an
653 assessment of the appropriateness of placement in a facility.
654 The findings of this examination must shall be recorded on the
655 examination form provided by the agency. The completed form must
656 shall accompany the resident and shall be submitted to the
657 facility owner or administrator. Additionally, in the case of a
658 mental health resident, the Department of Children and Families
659 must provide documentation that the individual has been assessed
660 by a psychiatrist, clinical psychologist, clinical social
661 worker, or psychiatric nurse, or an individual who is supervised
662 by one of these professionals, and determined to be appropriate
663 to reside in an assisted living facility. The documentation must
664 be in the facility within 30 days after the mental health
665 resident has been admitted to the facility. An evaluation
666 completed upon discharge from a state mental hospital meets the
667 requirements of this subsection related to appropriateness for
668 placement as a mental health resident, provided that providing
669 it was completed within 90 days before prior to admission to the
670 facility. The applicable Department of Children and Families
671 shall provide to the facility administrator any information
672 about the resident which that would help the administrator meet
673 his or her responsibilities under subsection (1). Further,
674 Department of Children and Families personnel shall explain to
675 the facility operator any special needs of the resident and
676 advise the operator whom to call should problems arise. The
677 applicable Department of Children and Families shall advise and
678 assist the facility administrator when where the special needs
679 of residents who are recipients of optional state
680 supplementation require such assistance.
681 (7) The facility shall must notify a licensed physician
682 when a resident exhibits signs of dementia or cognitive
683 impairment or has a change of condition in order to rule out the
684 presence of an underlying physiological condition that may be
685 contributing to such dementia or impairment. The notification
686 must occur within 30 days after the acknowledgment of such signs
687 by facility staff. If an underlying condition is determined to
688 exist, the facility must notify the resident’s representative or
689 designee of the need for health care services and must assist in
690 making appointments for shall arrange, with the appropriate
691 health care provider, the necessary care and services to treat
692 the condition. If the resident does not have a representative or
693 designee or if the resident’s representative or designee cannot
694 be located or is nonresponsive, the facility shall arrange with
695 an appropriate health care provider for the necessary care and
696 services to treat the condition.
697 (8) The Department of Children and Families may require an
698 examination for supplemental security income and optional state
699 supplementation recipients residing in facilities at any time
700 and shall provide the examination whenever a resident’s
701 condition requires it. Any facility administrator; personnel of
702 the agency, the department, or the Department of Children and
703 Families; or a representative of the State Long-Term Care
704 Ombudsman Program who believes a resident needs to be evaluated
705 shall notify the resident’s case manager, who shall take
706 appropriate action. A report of the examination findings must
707 shall be provided to the resident’s case manager and the
708 facility administrator to help the administrator meet his or her
709 responsibilities under subsection (1).
710 (9) A terminally ill resident who no longer meets the
711 criteria for continued residency may remain in the facility if
712 the arrangement is mutually agreeable to the resident and the
713 facility; additional care is rendered through a licensed
714 hospice, and the resident is under the care of a physician who
715 agrees that the physical needs of the resident are being met.
716 (9)(10) Facilities licensed to provide extended congregate
717 care services shall promote aging in place by determining
718 appropriateness of continued residency based on a comprehensive
719 review of the resident’s physical and functional status; the
720 ability of the facility, family members, friends, or any other
721 pertinent individuals or agencies to provide the care and
722 services required; and documentation that a written service plan
723 consistent with facility policy has been developed and
724 implemented to ensure that the resident’s needs and preferences
725 are addressed.
726 (11) No resident who requires 24-hour nursing supervision,
727 except for a resident who is an enrolled hospice patient
728 pursuant to part IV of chapter 400, shall be retained in a
729 facility licensed under this part.
730 Section 9. Paragraph (k) of subsection (1) and subsection
731 (3) of section 429.28, Florida Statutes, are amended to read:
732 429.28 Resident bill of rights.—
733 (1) No resident of a facility shall be deprived of any
734 civil or legal rights, benefits, or privileges guaranteed by
735 law, the Constitution of the State of Florida, or the
736 Constitution of the United States as a resident of a facility.
737 Every resident of a facility shall have the right to:
738 (k) At least 45 days’ notice of relocation or termination
739 of residency from the facility unless, for medical reasons, the
740 resident is certified by a physician to require an emergency
741 relocation to a facility providing a more skilled level of care
742 or the resident engages in a pattern of conduct that is harmful
743 or offensive to other residents. In the case of a resident who
744 has been adjudicated mentally incapacitated, the guardian shall
745 be given at least 45 days’ notice of a nonemergency relocation
746 or residency termination. Reasons for relocation must shall be
747 set forth in writing and provided to the resident or the
748 resident’s legal representative. In order for a facility to
749 terminate the residency of an individual without notice as
750 provided herein, the facility shall show good cause in a court
751 of competent jurisdiction.
752 (3)(a) The agency shall conduct a survey to determine
753 whether the facility is complying with this part general
754 compliance with facility standards and compliance with
755 residents’ rights as a prerequisite to initial licensure or
756 licensure renewal. The agency shall adopt rules for uniform
757 standards and criteria that will be used to determine compliance
758 with facility standards and compliance with residents’ rights.
759 (b) In order to determine whether the facility is
760 adequately protecting residents’ rights, the licensure renewal
761 biennial survey must shall include private informal
762 conversations with a sample of residents and consultation with
763 the ombudsman council in the district in which the facility is
764 located to discuss residents’ experiences within the facility.
765 Section 10. Subsections (1) and (2) of section 429.31,
766 Florida Statutes, are amended to read:
767 429.31 Closing of facility; notice; penalty.—
768 (1) In addition to the requirements of part II of chapter
769 408, the facility shall inform, in writing, the agency and each
770 resident or the next of kin, legal representative, or agency
771 acting on each resident’s behalf, of the fact and the proposed
772 time of discontinuance of operation, following the notification
773 requirements provided in s. 429.28(1)(k). In the event a
774 resident has no person to represent him or her, the facility
775 shall be responsible for referral to an appropriate social
776 service agency for placement.
777 (2) Immediately upon the notice by the agency of the
778 voluntary or involuntary termination of such operation, the
779 agency shall inform the State Long-Term Care Ombudsman Program
780 and monitor the transfer of residents to other facilities and
781 ensure that residents’ rights are being protected. The agency,
782 in consultation with the Department of Children and Families,
783 shall specify procedures for ensuring that all residents who
784 receive services are appropriately relocated.
785 Section 11. Subsections (1), (2), and (5) of section
786 429.41, Florida Statutes, are amended to read:
787 429.41 Rules establishing standards.—
788 (1) It is the intent of the Legislature that rules
789 published and enforced pursuant to this section shall include
790 criteria by which a reasonable and consistent quality of
791 resident care and quality of life may be ensured and the results
792 of such resident care may be demonstrated. Such rules shall also
793 promote ensure a safe and sanitary environment that is
794 residential and noninstitutional in design or nature and may
795 allow for technological advances in the provision of care,
796 safety, and security, including the use of devices, equipment,
797 and other security measures related to wander management,
798 emergency response, staff risk management, and the general
799 safety and security of residents, staff, and the facility. It is
800 further intended that reasonable efforts be made to accommodate
801 the needs and preferences of residents to enhance the quality of
802 life in a facility. Uniform firesafety standards for assisted
803 living facilities shall be established by the State Fire Marshal
804 pursuant to s. 633.206. The agency may adopt rules to administer
805 part II of chapter 408. In order to provide safe and sanitary
806 facilities and the highest quality of resident care
807 accommodating the needs and preferences of residents, The
808 agency, in consultation with the Department of Children and
809 Families and the Department of Health, shall adopt rules,
810 policies, and procedures to administer this part, which must
811 include reasonable and fair minimum standards in relation to:
812 (a) The requirements for and maintenance and the sanitary
813 condition of facilities, not in conflict with, or duplicative
814 of, the requirements in s. 381.006, s. 381.0072, chapter 553, or
815 s. 633.206, relating to a safe and decent living environment,
816 including furnishings for resident bedrooms or sleeping areas,
817 locking devices, linens plumbing, heating, cooling, lighting,
818 ventilation, living space, and other housing conditions relating
819 to hazards, which will promote ensure the health, safety, and
820 welfare comfort of residents suitable to the size of the
821 structure. The rules must clearly delineate the respective
822 responsibilities of the agency’s licensure and survey staff and
823 the county health departments and ensure that inspections are
824 not duplicative. The agency may collect fees for food service
825 inspections conducted by county health departments and may
826 transfer such fees to the Department of Health.
827 1. Firesafety evacuation capability determination.—An
828 evacuation capability evaluation for initial licensure shall be
829 conducted within 6 months after the date of licensure.
830 2. Firesafety requirements.—
831 a. The National Fire Protection Association, Life Safety
832 Code, NFPA 101 and 101A, current editions, shall be used in
833 determining the uniform firesafety code adopted by the State
834 Fire Marshal for assisted living facilities, pursuant to s.
835 633.206.
836 b. A local government or a utility may charge fees only in
837 an amount not to exceed the actual expenses incurred by the
838 local government or the utility relating to the installation and
839 maintenance of an automatic fire sprinkler system in a licensed
840 assisted living facility structure.
841 c. All licensed facilities must have an annual fire
842 inspection conducted by the local fire marshal or authority
843 having jurisdiction.
844 d. An assisted living facility that is issued a building
845 permit or certificate of occupancy before July 1, 2016, may at
846 its option and after notifying the authority having
847 jurisdiction, remain under the provisions of the 1994 and 1995
848 editions of the National Fire Protection Association, Life
849 Safety Code, NFPA 101, and NFPA 101A. The facility opting to
850 remain under such provisions may make repairs, modernizations,
851 renovations, or additions to, or rehabilitate, the facility in
852 compliance with NFPA 101, 1994 edition, and may utilize the
853 alternative approaches to life safety in compliance with NFPA
854 101A, 1995 edition. However, a facility for which a building
855 permit or certificate of occupancy is issued before July 1,
856 2016, that undergoes Level III building alteration or
857 rehabilitation, as defined in the Florida Building Code, or
858 seeks to utilize features not authorized under the 1994 or 1995
859 editions of the Life Safety Code must thereafter comply with all
860 aspects of the uniform firesafety standards established under s.
861 633.206, and the Florida Fire Prevention Code, in effect for
862 assisted living facilities as adopted by the State Fire Marshal.
863 3. Resident elopement requirements.—Facilities are required
864 to conduct a minimum of two resident elopement prevention and
865 response drills per year. All administrators and direct care
866 staff must participate in the drills, which shall include a
867 review of procedures to address resident elopement. Facilities
868 must document the implementation of the drills and ensure that
869 the drills are conducted in a manner consistent with the
870 facility’s resident elopement policies and procedures.
871 (b) The preparation and annual update of a comprehensive
872 emergency management plan. Such standards must be included in
873 the rules adopted by the agency after consultation with the
874 Division of Emergency Management. At a minimum, the rules must
875 provide for plan components that address emergency evacuation
876 transportation; adequate sheltering arrangements; postdisaster
877 activities, including provision of emergency power, food, and
878 water; postdisaster transportation; supplies; staffing;
879 emergency equipment; individual identification of residents and
880 transfer of records; communication with families; and responses
881 to family inquiries. The comprehensive emergency management plan
882 is subject to review and approval by the county local emergency
883 management agency. During its review, the county local emergency
884 management agency shall ensure that the following agencies, at a
885 minimum, are given the opportunity to review the plan: the
886 Department of Health, the Agency for Health Care Administration,
887 and the Division of Emergency Management. Also, appropriate
888 volunteer organizations must be given the opportunity to review
889 the plan. The county local emergency management agency shall
890 complete its review within 60 days and either approve the plan
891 or advise the facility of necessary revisions. A facility must
892 submit a comprehensive emergency management plan to the county
893 emergency management agency within 30 days after issuance of a
894 license.
895 (c) The number, training, and qualifications of all
896 personnel having responsibility for the care of residents. The
897 rules must require adequate staff to provide for the safety of
898 all residents. Facilities licensed for 17 or more residents are
899 required to maintain an alert staff for 24 hours per day.
900 (d) All sanitary conditions within the facility and its
901 surroundings which will ensure the health and comfort of
902 residents. The rules must clearly delineate the responsibilities
903 of the agency’s licensure and survey staff, the county health
904 departments, and the local authority having jurisdiction over
905 firesafety and ensure that inspections are not duplicative. The
906 agency may collect fees for food service inspections conducted
907 by the county health departments and transfer such fees to the
908 Department of Health.
909 (d)(e) License application and license renewal, transfer of
910 ownership, proper management of resident funds and personal
911 property, surety bonds, resident contracts, refund policies,
912 financial ability to operate, and facility and staff records.
913 (e)(f) Inspections, complaint investigations, moratoriums,
914 classification of deficiencies, levying and enforcement of
915 penalties, and use of income from fees and fines.
916 (f)(g) The enforcement of the resident bill of rights
917 specified in s. 429.28.
918 (g)(h) The care and maintenance of residents provided by
919 the facility, which must include, but is not limited to:
920 1. The supervision of residents;
921 2. The provision of personal services;
922 3. The provision of, or arrangement for, social and leisure
923 activities;
924 4. The assistance in making arrangements arrangement for
925 appointments and transportation to appropriate medical, dental,
926 nursing, or mental health services, as needed by residents;
927 5. The management of medication stored within the facility
928 and as needed by residents;
929 6. The dietary nutritional needs of residents;
930 7. Resident records; and
931 8. Internal risk management and quality assurance.
932 (h)(i) Facilities holding a limited nursing, extended
933 congregate care, or limited mental health license.
934 (i)(j) The establishment of specific criteria to define
935 appropriateness of resident admission and continued residency in
936 a facility holding a standard, limited nursing, extended
937 congregate care, and limited mental health license.
938 (j)(k) The use of physical or chemical restraints. The use
939 of Posey restraints is prohibited. Other physical restraints may
940 be used in accordance with agency rules when ordered is limited
941 to half-bed rails as prescribed and documented by the resident’s
942 physician and consented to by with the consent of the resident
943 or, if applicable, the resident’s representative or designee or
944 the resident’s surrogate, guardian, or attorney in fact. Such
945 rules must specify requirements for care planning, staff
946 monitoring, and periodic review by a physician. The use of
947 chemical restraints is limited to prescribed dosages of
948 medications authorized by the resident’s physician and must be
949 consistent with the resident’s diagnosis. Residents who are
950 receiving medications that can serve as chemical restraints must
951 be evaluated by their physician at least annually to assess:
952 1. The continued need for the medication.
953 2. The level of the medication in the resident’s blood.
954 3. The need for adjustments in the prescription.
955 (k)(l) The establishment of specific resident elopement
956 drill requirements and policies and procedures on resident
957 elopement. Facilities shall conduct a minimum of two resident
958 elopement drills each year. All administrators and direct care
959 staff shall participate in the drills, which must include a
960 review of the facility’s procedures to address resident
961 elopement. Facilities shall document participation in the
962 drills.
963 (2) In adopting any rules pursuant to this part, the agency
964 shall make distinct standards for facilities based upon facility
965 size; the types of care provided; the physical and mental
966 capabilities and needs of residents; the type, frequency, and
967 amount of services and care offered; and the staffing
968 characteristics of the facility. Rules developed pursuant to
969 this section may not restrict the use of shared staffing and
970 shared programming in facilities that are part of retirement
971 communities that provide multiple levels of care and otherwise
972 meet the requirements of law and rule. If a continuing care
973 facility licensed under chapter 651 or a retirement community
974 offering multiple levels of care licenses a building or part of
975 a building designated for independent living for assisted
976 living, staffing requirements established in rule apply only to
977 residents who receive personal, limited nursing, or extended
978 congregate care services under this part. Such facilities shall
979 retain a log listing the names and unit number for residents
980 receiving these services. The log must be available to surveyors
981 upon request. Except for uniform firesafety standards, The
982 agency shall adopt by rule separate and distinct standards for
983 facilities with 16 or fewer beds and for facilities with 17 or
984 more beds. The standards for facilities with 16 or fewer beds
985 must be appropriate for a noninstitutional residential
986 environment; however, the structure may not be more than two
987 stories in height and all persons who cannot exit the facility
988 unassisted in an emergency must reside on the first floor. The
989 agency may make other distinctions among types of facilities as
990 necessary to enforce this part. Where appropriate, the agency
991 shall offer alternate solutions for complying with established
992 standards, based on distinctions made by the agency relative to
993 the physical characteristics of facilities and the types of care
994 offered.
995 (5) The agency may use an abbreviated biennial standard
996 licensure inspection that consists of a review of key quality
997 of-care standards in lieu of a full inspection in a facility
998 that has a good record of past performance. However, a full
999 inspection must be conducted in a facility that has a history of
1000 class I or class II violations;, uncorrected class III
1001 violations; or a class I, class II, or uncorrected class III
1002 violation resulting from a complaint referred by the State Long
1003 Term Care Ombudsman Program, confirmed ombudsman council
1004 complaints, or confirmed licensure complaints within the
1005 previous licensure period immediately preceding the inspection
1006 or if a potentially serious problem is identified during the
1007 abbreviated inspection. The agency shall adopt by rule develop
1008 the key quality-of-care standards with input from the State
1009 Long-Term Care Ombudsman Council and representatives of provider
1010 groups for incorporation into its rules.
1011 Section 12. Section 429.435, Florida Statutes, is created
1012 to read:
1013 429.435 Uniform firesafety standards.—Uniform firesafety
1014 standards for assisted living facilities that are residential
1015 board and care occupancies shall be established by the State
1016 Fire Marshal pursuant to s. 633.206.
1017 (1) EVACUATION CAPABILITY.—A firesafety evacuation
1018 capability determination shall be conducted within 6 months
1019 after the date of initial licensure of an assisted living
1020 facility, if required.
1021 (2) FIRESAFETY REQUIREMENTS.—
1022 (a) The National Fire Protection Association, Life Safety
1023 Code, NFPA 101 and 101A, current editions, must be used in
1024 determining the uniform firesafety code adopted by the State
1025 Fire Marshal for assisted living facilities, pursuant to s.
1026 633.206.
1027 (b) A local government or a utility may charge fees that do
1028 not exceed the actual costs incurred by the local government or
1029 the utility for the installation and maintenance of an automatic
1030 fire sprinkler system in a licensed assisted living facility
1031 structure.
1032 (c) All licensed facilities must have an annual fire
1033 inspection conducted by the local fire marshal or authority
1034 having jurisdiction.
1035 (d) An assisted living facility that was issued a building
1036 permit or certificate of occupancy before July 1, 2016, at its
1037 option and after notifying the authority having jurisdiction,
1038 may remain under the provisions of the 1994 and 1995 editions of
1039 the National Fire Protection Association, Life Safety Code, NFPA
1040 101 and 101A. A facility opting to remain under such provisions
1041 may make repairs, modernizations, renovations, or additions to
1042 or rehabilitate the facility in compliance with NFPA 101, 1994
1043 edition, and may use the alternative approaches to life safety
1044 in compliance with NFPA 101A, 1995 edition. However, a facility
1045 for which a building permit or certificate of occupancy was
1046 issued before July 1, 2016, which undergoes Level III building
1047 alteration or rehabilitation, as defined in the Florida Building
1048 Code, or which seeks to use features not authorized under the
1049 1994 or 1995 editions of the Life Safety Code, shall thereafter
1050 comply with all aspects of the uniform firesafety standards
1051 established under s. 633.206 and the Florida Fire Prevention
1052 Code in effect for assisted living facilities as adopted by the
1053 State Fire Marshal.
1054 Section 13. Section 429.52, Florida Statutes, is amended to
1055 read:
1056 429.52 Staff training and educational requirements
1057 programs; core educational requirement.—
1058 (1) Effective October 1, 2015, Each new assisted living
1059 facility employee who has not previously completed core training
1060 must attend a preservice orientation provided by the facility
1061 before interacting with residents. The preservice orientation
1062 must be at least 2 hours in duration and cover topics that help
1063 the employee provide responsible care and respond to the needs
1064 of facility residents. Upon completion, the employee and the
1065 administrator of the facility must sign a statement that the
1066 employee completed the required preservice orientation. The
1067 facility must keep the signed statement in the employee’s
1068 personnel record.
1069 (2) Administrators and other assisted living facility staff
1070 must meet minimum training and education requirements
1071 established by the agency by rule. This training and education
1072 is intended to assist facilities to appropriately respond to the
1073 needs of residents, to maintain resident care and facility
1074 standards, and to meet licensure requirements.
1075 (3) The agency, in conjunction with providers, shall
1076 develop core training requirements for administrators consisting
1077 of core training learning objectives, a competency test, and a
1078 minimum required score to indicate successful passage completion
1079 of the core competency test training and educational
1080 requirements. The required core competency test training and
1081 education must cover at least the following topics:
1082 (a) State law and rules relating to assisted living
1083 facilities.
1084 (b) Resident rights and identifying and reporting abuse,
1085 neglect, and exploitation.
1086 (c) Special needs of elderly persons, persons with mental
1087 illness, and persons with developmental disabilities and how to
1088 meet those needs.
1089 (d) Nutrition and food service, including acceptable
1090 sanitation practices for preparing, storing, and serving food.
1091 (e) Medication management, recordkeeping, and proper
1092 techniques for assisting residents with self-administered
1093 medication.
1094 (f) Firesafety requirements, including fire evacuation
1095 drill procedures and other emergency procedures.
1096 (g) Care of persons with Alzheimer’s disease and related
1097 disorders.
1098 (4) A new facility administrator must complete the required
1099 core training and education, including the competency test,
1100 within 90 days after the date of employment as an administrator.
1101 Failure to do so is a violation of this part and subjects the
1102 violator to an administrative fine as prescribed in s. 429.19.
1103 Administrators licensed in accordance with part II of chapter
1104 468 are exempt from this requirement. Other licensed
1105 professionals may be exempted, as determined by the agency by
1106 rule.
1107 (5) Administrators are required to participate in
1108 continuing education for a minimum of 12 contact hours every 2
1109 years.
1110 (6) Staff involved with the management of medications and
1111 assisting with the self-administration of medications under s.
1112 429.256 must complete a minimum of 6 additional hours of
1113 training provided by a registered nurse or, a licensed
1114 pharmacist before providing assistance, or agency staff. Two
1115 hours of continuing education are required annually thereafter.
1116 The agency shall establish by rule the minimum requirements of
1117 this additional training.
1118 (7) Other Facility staff shall participate in inservice
1119 training relevant to their job duties as specified by agency
1120 rule of the agency. Topics covered during the preservice
1121 orientation are not required to be repeated during inservice
1122 training. A single certificate of completion which covers all
1123 required inservice training topics may be issued to a
1124 participating staff member if the training is provided in a
1125 single training course.
1126 (8) If the agency determines that there are problems in a
1127 facility which could be reduced through specific staff training
1128 or education beyond that already required under this section,
1129 the agency may require, and provide, or cause to be provided,
1130 the training or education of any personal care staff in the
1131 facility.
1132 (9) The agency shall adopt rules related to these training
1133 and education requirements, the competency test, necessary
1134 procedures, and competency test fees and shall adopt or contract
1135 with another entity to develop and administer the competency
1136 test. The agency shall adopt a curriculum outline with learning
1137 objectives to be used by core trainers, which shall be used as
1138 the minimum core training content requirements. The agency shall
1139 consult with representatives of stakeholder associations and
1140 agencies in the development of the curriculum outline.
1141 (10) The core training required by this section other than
1142 the preservice orientation must be conducted by persons
1143 registered with the agency as having the requisite experience
1144 and credentials to conduct the training. A person seeking to
1145 register as a core trainer must provide the agency with proof of
1146 completion of the minimum core training education requirements,
1147 successful passage of the competency test established under this
1148 section, and proof of compliance with the continuing education
1149 requirement in subsection (5).
1150 (11) A person seeking to register as a core trainer also
1151 must also:
1152 (a) Provide proof of completion of a 4-year degree from an
1153 accredited college or university and must have worked in a
1154 management position in an assisted living facility for 3 years
1155 after being core certified;
1156 (b) Have worked in a management position in an assisted
1157 living facility for 5 years after being core certified and have
1158 1 year of teaching experience as an educator or staff trainer
1159 for persons who work in assisted living facilities or other
1160 long-term care settings;
1161 (c) Have been previously employed as a core trainer for the
1162 agency or department; or
1163 (d) Meet other qualification criteria as defined in rule,
1164 which the agency is authorized to adopt.
1165 (12) The agency shall adopt rules to establish core trainer
1166 registration and removal requirements.
1167 Section 14. This act shall take effect July 1, 2020.