November 28, 2020
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Florida Senate - 2008 SB 1668

By Senator Jones

13-03025B-08 20081668__

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A bill to be entitled

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An act relating to long-term care facilities; amending s.

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400.021, F.S.; revising definitions relating to nursing

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homes; defining the terms "affiliate," "controlling

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entity," "controlling financial interest," "entity," and

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"governing body"; amending s. 400.071, F.S.; revising

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provisions relating to nursing home license applications;

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requiring the application to include the members of the

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facility's governing body, the facility's affiliates and

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controlling entities, entities having a controlling

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interest in the facility, an audited financial statement,

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proof of ability to operate, certain contracts, and copies

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of certain investigations and fines; amending s. 400.102,

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F.S.; revising grounds for taking action against a nursing

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home to conform to changes made by the act; amending s.

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400.111, F.S.; requiring the disclosure of controlling

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interests at the time of licensure, license renewal, or

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change of ownership; amending s. 400.121, F.S.; revising

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provisions relating to the denial, suspension, or

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revocation of a license to conform to changes made by the

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act; amending s. 400.141, F.S.; prohibiting nursing home

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liability insurance from paying for certain legal costs;

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amending s. 400.191, F.S.; requiring that the Agency for

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Health Care Administration include additional information

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in the Nursing Home Guide; creating s. 400.197, F.S.;

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requiring a nursing home to notify residents and post a

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request for a change of ownership in prominent locations

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in the nursing home; providing for a hearing as to the

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fitness of a new owner; providing for investigations of

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the new owner; providing that a new owner assumes the

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liabilities of the prior licensee; amending s. 429.02,

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F.S.; revising definitions for assisted living facilities;

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defining the terms "affiliate," "controlling entity,"

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"controlling financial interest," and "entity"; amending

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s. 429.11, F.S.; revising provisions relating to

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applications for an assisted living facility license;

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requiring the application to include members of the

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facilities governing body, the facility's affiliates and

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controlling entities, entities having a controlling

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interest in the facility, an audited financial statement,

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proof of ability to operate, certain contracts, and copies

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of certain investigations and fines; amending s. 429.12,

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F.S.; requiring the assisted living facility to notify

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residents and post a request for a change of ownership in

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prominent locations in the facility; providing for a

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hearing as to the fitness of a new owner upon request;

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providing for investigations of the new owner; providing

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that a new owner assumes the liabilities of the prior

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licensee; amending s. 429.14, F.S.; revising provisions

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relating to the denial, suspension, or revocation of a

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license to conform to changes made by the act; amending s.

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429.275, F.S.; prohibiting assisted living facility

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liability insurance from paying for certain legal costs;

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amending s. 429.174, F.S.; conforming a cross-reference;

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providing an effective date.

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Be It Enacted by the Legislature of the State of Florida:

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     Section 1.  Subsections (2) through (18) of section 400.021,

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Florida Statutes, are renumbered as subsections (3) through (23),

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respectively, new subsections (2), (6), (7), (10), and (14) are

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added to that section, and present subsections (2) through (9) of

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that sections are amended, to read:

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     400.021  Definitions.-- When used in this part, unless the

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context otherwise requires, the term:

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     (2) "Affiliate" means an entity having the same or similar

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owners, officers, board members, directors, limited liability

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corporation members, operating company, management company, or

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address as a facility.

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     (3)(2) "Agency" means the Agency for Health Care

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Administration, which is the licensing agency under this part.

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     (4)(3) "Bed reservation policy" means the number of

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consecutive days and the number of days per year that a resident

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may leave the nursing home facility for overnight therapeutic

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visits with family or friends or for hospitalization for an acute

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condition before the licensee may discharge the resident due to

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his or her absence from the facility.

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     (5)(4) "Board" means the Board of Nursing Home

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Administrators.

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     (6) "Controlling entity" means an entity that exhibits

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control over a facility, including, but not limited to, control

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over resident care, the facility's budget, staffing levels,

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setting or monitoring census goals, employment decisions, capital

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purchases, facility improvements, plant improvements, access to

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or use of the facility's assets or equipment, financing or

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lending agreements, or the business decisions of the facility.

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     (7) "Controlling financial interest" means having a 5

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percent or greater financial ownership interest in the facility,

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an affiliate, or controlling entity.

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     (8)(5) "Custodial service" means care for a person which

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entails observation of diet and sleeping habits and maintenance

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of a watchfulness over the general health, safety, and well-being

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of the aged or infirm.

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     (9)(6) "Department" means the Department of Children and

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Family Services.

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     (10) "Entity" means an individual, partnership,

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association, joint venture, company, sole proprietorship,

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corporation, limited liability corporation, professional limited

99

liability corporation, or any other form of doing business.

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     (11)(7) "Facility" means an any institution, building,

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residence, private home, or other place, whether operated for

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profit or not, including a place operated by a county or

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municipality, which undertakes through its ownership or

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management to provide for a period exceeding 24-hour nursing

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care, personal care, or custodial care for three or more persons

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not related to the owner or manager by blood or marriage, who by

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reason of illness, physical infirmity, or advanced age require

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such services, but does not include any place providing care and

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treatment primarily for the acutely ill. A facility offering

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services for fewer than three persons is within the meaning of

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this definition if it holds itself out to the public to be an

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establishment that which regularly provides such services.

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     (12)(8) "Geriatric outpatient clinic" means a site for

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providing outpatient health care to persons 60 years of age or

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older, which is staffed by a registered nurse or a physician

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assistant.

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     (13)(9) "Geriatric patient" means a any patient who is 60

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years of age or older.

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     (14) "Governing body" means the individuals who have

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responsibility for hiring the administrator and for approving a

121

facility's policies and procedures and ensuring their proper

122

implementation.

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     Section 2.  Subsection (1) of section 400.071, Florida

124

Statutes, is amended to read:

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     400.071  Application for license.--

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     (1)  In addition to the requirements of part II of chapter

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408, the application for a license under this part must shall be

128

under oath and must contain the following:

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     (a)  The location of the facility for which a license is

130

sought and an indication, as in the original application, that

131

the such location conforms to the local zoning ordinances.

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     (b) The names and dates of service of the members of the

133

applicant's governing body.

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     (c) A signed affidavit disclosing any affiliate of,

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controlling entity of, and entity having a controlling financial

136

interest in the applicant.

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     (d)(b) A signed affidavit disclosing any financial or

138

ownership interest that the applicant, an affiliate, a

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controlling entity, or an entity having a controlling financial

140

interest as defined in part II of chapter 408 has held in the

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last 5 years in any entity licensed by this state or any other

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state to provide health or residential care which has closed

143

voluntarily or involuntarily; has filed for bankruptcy; has had a

144

receiver appointed; has had a license denied, suspended, or

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revoked; or has had an injunction issued against it which was

146

initiated by a regulatory agency. The affidavit must disclose the

147

reason the any such entity was closed, whether voluntarily or

148

involuntarily.

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     (e)(c) The total number of beds and the total number of

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Medicare and Medicaid certified beds.

151

     (f)(d) Information relating to the applicant and employees

152

which the agency requires by rule. The applicant must demonstrate

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that sufficient numbers of qualified staff, by training or

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experience, will be employed to properly care for the type and

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number of residents who will reside in the facility.

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     (g) An audited financial statement of the applicant if an

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audited financial statement has been prepared for the applicant

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or the controlling entity. If the application relates to a change

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of ownership of a current licensee, financial documentation must

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include, but need not be limited to, the balance sheet and profit

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and loss statement of the nursing home's 2 previous fiscal years

162

of operation.

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     (h) Proof of financial ability to operate. The applicant

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must demonstrate an ability to provide staff at required levels

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and maintain solvency in accordance with this part, applicable

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provisions of chapter 408, and related rules. Documentation may

167

include a statement of the projected revenue and expenses for the

168

first 12 months of operation following licensure, a detailed

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explanation of the assumptions implicit in these projections, the

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basis for financing the applicant's anticipated cash-flow

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requirements, and the applicant's access to contingency

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financing.

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     (i) Any contracts with affiliates or controlling entities,

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including details of goods or services provided and the intended

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payment for those services.

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     (j) Copies of any audits, investigations, or fines related

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to the receipt or use of federal or state funds by all

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affiliates, controlling entities, and entities having a

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controlling financial interest. These include the results of or

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any ongoing investigations into Medicaid or Medicare fraud or

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Medicaid or Medicare overpayment, any standing corporate

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integrity agreements, or other remedial action by a public

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entity.

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     (k)(e) Copies of any civil verdict or judgment involving

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the applicant, affiliates, or controlling entities rendered

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within the 10 years preceding the application, relating to

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medical negligence, violation of residents' rights, or wrongful

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death. As a condition of licensure, the licensee agrees to

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provide to the agency copies of any new verdict or judgment

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involving the applicant, relating to such matters, within 30 days

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after filing with the clerk of the court. The information must

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required in this paragraph shall be maintained in the facility's

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licensure file and in an agency database that which is available

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as a public record.

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     Section 3.  Section 400.102, Florida Statutes, is amended to

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read:

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     400.102  Action by agency against licensee; grounds.--In

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addition to the grounds listed in part II of chapter 408, any of

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the following conditions shall be grounds for action by the

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agency against a licensee:

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     (1)  An intentional or negligent act materially affecting

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the health or safety of residents of the facility.;

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     (2)  Misappropriation or conversion of the property of a

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resident of the facility.;

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     (3)  Failure to follow the criteria and procedures provided

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under part I of chapter 394 relating to the transportation,

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voluntary admission, and involuntary examination of a nursing

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home resident.; or

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     (4)  Fraudulent altering, defacing, or falsifying any

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medical or nursing home records, or causing or procuring any of

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these offenses to be committed.

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     (5) Failure to disclose at the time of licensure, license

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renewal, or change of ownership all affiliates, controlling

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entities, entities having a controlling financial interest, or

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members of the governing body.

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     Section 4.  Section 400.111, Florida Statutes, is amended to

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read:

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     400.111  Disclosure of controlling interest.--In addition to

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the requirements of part II of chapter 408, the licensee shall at

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the time of licensure, license renewal, or change of ownership

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submit a signed affidavit disclosing any financial or ownership

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interest that an affiliate, controlling entity, or entity having

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a controlling financial interest has held within the last 5 years

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in any entity licensed by the state or any other state to provide

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health or residential care which entity has closed voluntarily or

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involuntarily; has filed for bankruptcy; has had a receiver

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appointed; has had a license denied, suspended, or revoked; or

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has had an injunction issued against it which was initiated by a

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regulatory agency. The affidavit must disclose the reason such

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entity was closed, whether voluntarily or involuntarily. As a

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condition of licensure, license renewal, or change of ownership,

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the licensee must agree to provide to the agency a signed

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affidavit disclosing such interest within 30 days after the

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acquisition.

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     Section 5.  Subsections (1) and (3) of section 400.121,

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Florida Statutes, are amended to read:

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     400.121  Denial, suspension, revocation of license;

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administrative fines; procedure; order to increase staffing.--

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     (1) The agency may deny a license an application, revoke or

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suspend a license, and impose an administrative fine, not to

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exceed $500 per violation per day for the violation of any

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provision of this part, part II of chapter 408, or applicable

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rules, against any applicant or licensee for the following

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violations by the applicant, licensee, or other controlling

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interest:

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     (a)  A violation of any provision of this part, part II of

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chapter 408, or applicable rules; or

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     (b)  An adverse action by a regulatory agency against any

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other licensed facility that has a common controlling entity or

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an entity having controlling financial interest in the applicant

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or with the licensee or applicant against whom the action under

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this section is being brought. If the adverse action involves

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solely the management company, the applicant or licensee shall be

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given 30 days to remedy before final action is taken. If the

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adverse action is based solely upon actions by the a controlling

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entity or entity having a controlling financial interest, the

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applicant or licensee may present factors in mitigation of a any

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proposed penalty based upon a showing that such penalty is

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inappropriate under the circumstances.

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All hearings shall be held within the county in which the

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licensee or applicant operates or applies for a license to

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operate a facility as defined herein.

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     (3)  The agency shall revoke or deny a nursing home license

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if the licensee, a controlling entity, or an entity having a

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controlling financial interest in the licensee operates a

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facility in this state that:

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     (a)  Has had two moratoria issued pursuant to this part or

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part II of chapter 408 which are imposed by final order for

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substandard quality of care, as defined by 42 C.F.R. part 483,

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within a any 30-month period;

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     (b)  Is conditionally licensed for 180 or more continuous

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days;

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     (c)  Is cited for two class I deficiencies arising from

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unrelated circumstances during the same survey or investigation;

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or

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     (d)  Is cited for two class I deficiencies arising from

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separate surveys or investigations within a 30-month period.

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The licensee may present factors in mitigation of revocation, and

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the agency may make a determination not to revoke a license based

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upon a showing that revocation is inappropriate under the

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circumstances.

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     Section 6.  Subsections (14) and (20) of section 400.141,

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Florida Statutes, are amended to read:

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     400.141  Administration and management of nursing home

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facilities.--Every licensed facility shall comply with all

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applicable standards and rules of the agency and shall:

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     (14) Submit to the agency the information specified in s.

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400.071(1)(d) s. 400.071(1)(b) for a management company within 30

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days after the effective date of the management agreement.

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     (20)  Maintain general and professional liability insurance

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coverage that is in force at all times. The liability insurance

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may not be used for the litigation costs or attorney's fees for

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the defense of a claim against a nursing home pursuant to the

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common law, s. 400.023, or s. 400.0233. The licensee must notify

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the agency immediately if the policy limits have been exhausted.

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In lieu of general and professional liability insurance coverage,

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a state-designated teaching nursing home and its affiliated

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assisted living facilities created under s. 430.80 may

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demonstrate proof of financial responsibility as provided in s.

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430.80(3)(h).

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304

Facilities that have been awarded a Gold Seal under the program

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established in s. 400.235 may develop a plan to provide certified

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nursing assistant training as prescribed by federal regulations

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and state rules and may apply to the agency for approval of their

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program.

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     Section 7.  Subsections (2) and (5) of section 400.191,

310

Florida Statutes, are amended to read:

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     400.191  Availability, distribution, and posting of reports

312

and records.--

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     (2)  The agency shall publish the Nursing Home Guide

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annually in consumer-friendly printed form and quarterly in

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electronic form to assist consumers and their families in

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comparing and evaluating nursing home facilities.

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     (a) The agency shall establish provide an Internet site

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that, at a minimum, includes which shall include at least the

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following information either directly or indirectly through a

320

link to other another established site or sites of the agency's

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choosing:

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     1.  A section entitled "Have you considered programs that

323

provide alternatives to nursing home care?" which shall be the

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first section of the Nursing Home guide and which shall

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prominently display information about available alternatives to

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nursing homes and how to obtain additional information regarding

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these alternatives. The Nursing Home guide shall explain that

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this state offers alternative programs that allow permit

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qualified elderly persons to stay in their homes instead of being

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placed in nursing homes and shall encourage interested persons to

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call the Comprehensive Assessment Review and Evaluation for Long-

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Term Care Services (CARES) Program to inquire if they qualify.

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The Nursing Home guide shall list available home and community-

334

based programs and which shall clearly state the services that

335

are provided and indicate whether nursing home services are

336

included if needed.

337

     2.  A list by name and address of all nursing home

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facilities in this state, including any prior name by which a

339

facility was known during the previous 24-month period. The

340

agency shall provide the following information for each facility

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listed:

342

     a.3. Whether the facility is such nursing home facilities

343

are proprietary or nonproprietary.

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     b.4. The current owner or owners of the facility's license

345

and the year in which that that entity became the owner of the

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license.

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     c. The name of the administrator and of all members of the

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facility's governing body, including their dates of service.

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     d.5. The name of the owner or owners of the each facility

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and whether the facility is affiliated with a company or other

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organization owning or managing more than one nursing facility in

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this state.

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     e. A list of all affiliates, controlling entities, and

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entities having a controlling financial interest that are

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affiliated with or associated with the facility.

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     f. Any documents related to audits, investigations, or

357

fines related to the receipt or use of federal or state funds by

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the facility, or any affiliate, controlling entity, or entity

359

having a controlling financial interest, including all related

360

documents submitted under s. 400.071.

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     g.6. The total number of beds in the each facility and the

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most recently available occupancy levels.

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     h.7. The number of private and semiprivate rooms in the

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each facility.

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     i.8. The religious affiliation, if any, of the each

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facility.

367

     j.9. The languages spoken by the administrator and staff of

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the each facility.

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     k.10. Whether the or not each facility accepts Medicare or

370

Medicaid recipients or insurance, health maintenance

371

organization, Veterans Administration, CHAMPUS program, or

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workers' compensation coverage.

373

     l.11. Recreational programs, special care units, and other

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programs available at the each facility.

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     m.12. Special care units or programs offered at the each

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facility.

377

     n.13. Whether the facility is a part of a retirement

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community that offers other services pursuant to part III of this

379

chapter or part I or part III of chapter 429.

380

     o.14. Survey and deficiency information, including all

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federal and state recertification, licensure, revisit, and

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complaint survey information, for the each facility for the past

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30 months. For noncertified nursing homes, state survey and

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deficiency information, including licensure, revisit, and

385

complaint survey information for the past 30 months shall be

386

provided.

387

     p.15. A summary of the deficiency data for the each

388

facility during over the past 30 months. The summary may include

389

a score, rating, or comparison ranking with respect to other

390

facilities based on the number of citations received by the

391

facility on recertification, licensure, revisit, and complaint

392

surveys; the severity and scope of the citations; and the number

393

of recertification surveys the facility has had during the past

394

30 months. The score, rating, or comparison ranking may be

395

presented in either numeric or symbolic form for the intended

396

consumer audience.

397

     3. A list, by name and address, of all nursing home

398

facilities that have submitted an application for a change of

399

ownership, including the date of the submission and current

400

status of that application. The list must be updated within 21

401

days after the agency's receipt of an application for change of

402

ownership or any change in the status of the application.

403

     (b)  The agency shall provide the following information in

404

printed form:

405

     1.  A section entitled "Have you considered programs that

406

provide alternatives to nursing home care?" which shall be the

407

first section of the Nursing Home guide and which shall

408

prominently display information about available alternatives to

409

nursing homes and how to obtain additional information regarding

410

these alternatives. The Nursing Home guide shall explain that

411

this state offers alternative programs that allow permit

412

qualified elderly persons to stay in their homes instead of being

413

placed in nursing homes and shall encourage interested persons to

414

call the Comprehensive Assessment Review and Evaluation for Long-

415

Term Care Services (CARES) Program to inquire if they qualify.

416

The Nursing Home guide shall list available home and community-

417

based programs and which shall clearly state the services that

418

are provided and indicate whether nursing home services are

419

included if needed.

420

     2.  A list by name and address of all nursing home

421

facilities in this state. The agency shall provide the following

422

information for each facility listed:

423

     a.3. Whether the facility is nursing home facilities are

424

proprietary or nonproprietary.

425

     b.4. The current owner or owners of the facility's license

426

and the year that entity became the owner of the license.

427

     c.5. The total number of beds, and of private and

428

semiprivate rooms, in the each facility.

429

     d.6. The religious affiliation, if any, of the each

430

facility.

431

     e.7. The name of the owner or owners of the each facility

432

and whether the facility is affiliated with a company or other

433

organization owning or managing more than one nursing facility in

434

this state.

435

     f.8. The languages spoken by the administrator and staff of

436

the each facility.

437

     g.9. Whether the or not each facility accepts Medicare or

438

Medicaid recipients or insurance, health maintenance

439

organization, Veterans Administration, CHAMPUS program, or

440

workers' compensation coverage.

441

     h.10. Recreational programs, special care units, and other

442

programs available at the each facility.

443

     11. The Internet address for the site where more detailed

444

information can be seen.

445

     12. A statement advising consumers that each facility will

446

have its own policies and procedures related to protecting

447

resident property.

448

     i.13. A summary of the deficiency data for the each

449

facility during over the past 30 months. The summary may include

450

a score, rating, or comparison ranking with respect to other

451

facilities based on the number of citations received by the

452

facility on recertification, licensure, revisit, and complaint

453

surveys; the severity and scope of the citations; the number of

454

citations; and the number of recertification surveys the facility

455

has had during the past 30 months. The score, rating, or

456

comparison ranking may be presented in either numeric or symbolic

457

form for the intended consumer audience.

458

     3. A statement advising consumers that each facility has

459

its own policies and procedures related to protecting resident

460

property.

461

     4. The Internet address for the agency site where more

462

detailed information about facilities can be found.

463

     (c)  The agency may provide the following additional

464

information on an Internet site or in printed form as the

465

information becomes available:

466

     1.  The licensure status history of each facility.

467

     2.  The rating history of each facility.

468

     3.  The regulatory history of each facility, which may

469

include federal sanctions, state sanctions, federal fines, state

470

fines, and other actions.

471

     4.  Whether the facility currently possesses the Gold Seal

472

designation awarded pursuant to s. 400.235.

473

     5. Known Internet links to the Internet sites of the

474

facilities, or their affiliates, controlling entities, and

475

entities having a controlling financial interest.

476

     (5)  Every nursing home facility licensee shall:

477

     (a) Post, in a sufficient number of prominent locations

478

positions in the nursing home in order so as to be accessible to

479

all residents and to the general public:

480

     1.  A concise summary of the last inspection report

481

pertaining to the nursing home and issued by the agency, with

482

references to the page numbers of the full reports, noting any

483

deficiencies found by the agency and the actions taken by the

484

licensee to rectify the deficiencies and indicating in the

485

summaries where the full reports may be inspected in the nursing

486

home.

487

     2. A copy of all of the pages that list the facility in the

488

most recent version of the Nursing Home Guide.

489

     3. A copy of any conditional license in effect regardless

490

of an administrative or judicial challenge.

491

     (b) Upon request, provide to a prospective resident any

492

person who has completed a written application for admission with

493

an intent to be admitted to, or to a any resident of, a nursing

494

home, or to any relative, spouse, surrogate, or guardian of the

495

person, a copy of the agency's last inspection report of

496

pertaining to the nursing home if and issued by the agency,

497

provided the person requesting the report agrees to pay a

498

reasonable charge to cover copying costs.

499

     Section 8.  Section 400.197, Florida Statutes, is created to

500

read:

501

     400.197 Change of ownership.--

502

     (1) If the licensee submits a request for a change of

503

ownership to the agency, the licensee must notify all residents

504

and post the request in a sufficient number of prominent

505

locations in the nursing home and on the primary Internet site of

506

the facility in order for such information to be accessible to

507

all residents and to the public. The notice must be posted within

508

5 days after submitting the request to the agency.

509

     (2) Affected parties, including, but not limited to, a

510

resident, a resident's family member, a resident's legal

511

representative, a resident's guardian, and facility staff may

512

submit information for the agency to consider in evaluating the

513

proposed owner's character, experience, background,

514

qualifications, and fitness for the license when determining

515

whether to grant a change of ownership.

516

     (3) The agency may propound any reasonable interrogatories

517

in addition to those contained in the request, or conduct further

518

investigations as necessary for the protection of the public and

519

to ascertain the proposed owner's character, experience,

520

background, qualifications, and fitness for the license.

521

     (4) Upon granting a change of ownership, the new licensee

522

assumes all liabilities relative to prior licensees and

523

affiliates and controlling entities of the prior licensee.

524

     Section 9.  Subsections (3) though (26) of section 429.02,

525

Florida Statutes, are renumbered as subsections (4) through (30),

526

respectively, new subsection (3), (9), (10), and (14) are added

527

to that section, and present subsections (3) through (10) of that

528

section are amended, to read:

529

     429.02  Definitions.--When used in this part, the term:

530

     (3) "Affiliate" means an entity having the same or similar

531

owners, officers, board members, directors, limited liability

532

corporation members, operating company, management company, or

533

address as an assisted living facility.

534

     (4)(3) "Agency" means the Agency for Health Care

535

Administration.

536

     (5)(4) "Aging in place" or "age in place" means the process

537

of providing increased or adjusted services to a person to

538

compensate for the physical or mental decline that may occur with

539

the aging process, in order to maximize the person's dignity and

540

independence and allow permit them to remain in a familiar,

541

noninstitutional, residential environment for as long as

542

possible. Such services may be provided by facility staff,

543

volunteers, family, or friends, or through contractual

544

arrangements with a third party.

545

     (6)(5) "Assisted living facility" means any building or

546

buildings, section or distinct part of a building, private home,

547

boarding home, home for the aged, or other residential facility,

548

whether operated for profit or not, which undertakes through its

549

ownership or management to provide housing, meals, and one or

550

more personal services for a period exceeding 24 hours to one or

551

more adults who are not relatives of the owner or administrator.

552

     (7)(6) "Chemical restraint" means a pharmacologic drug that

553

physically limits, restricts, or deprives an individual of

554

movement or mobility, and is used for discipline or convenience

555

and not required for the treatment of medical symptoms.

556

     (8)(7) "Community living support plan" means a written

557

document prepared by a mental health resident and the resident's

558

mental health case manager in consultation with the administrator

559

of an assisted living facility with a limited mental health

560

license or the administrator's designee. A copy must be provided

561

to the administrator. The plan must include information about the

562

supports, services, and special needs of the resident which

563

enable the resident to live in the assisted living facility and a

564

method by which facility staff can recognize and respond to the

565

signs and symptoms particular to that resident which indicate the

566

need for professional services.

567

     (9) "Controlling entity" means an entity that exhibits

568

control over an assisted living facility, including, but not

569

limited to, control over resident care, the facility's budget,

570

staffing levels, setting or monitoring census goals, employment

571

decisions, capital purchases, facility improvements, plant

572

improvements, access to or use of the facility's assets or

573

equipment, financing or lending agreements, or the business

574

decisions of the facility.

575

     (10) "Controlling financial interest" means having a 5

576

percent or greater financial ownership interest in an assisted

577

living facility, an affiliate, or controlling entity.

578

     (11)(8) "Cooperative agreement" means a written statement

579

of understanding between a mental health care provider and the

580

administrator of the assisted living facility with a limited

581

mental health license in which a mental health resident is

582

living. The agreement must specify directions for accessing

583

emergency and after-hours care for the mental health resident. A

584

single cooperative agreement may service all mental health

585

residents who are clients of the same mental health care

586

provider.

587

     (12)(9) "Department" means the Department of Elderly

588

Affairs.

589

     (13)(10) "Emergency" means a situation, physical condition,

590

or method of operation which presents imminent danger of death or

591

serious physical or mental harm to facility residents.

592

     (14) "Entity" means an individual, partnership,

593

association, joint venture, company, sole proprietorship,

594

corporation, limited liability corporation, professional limited

595

liability corporation, or any other form of doing business.

596

     Section 10.  Subsection (1) of section 429.11, Florida

597

Statutes, is amended, and subsection (8) is added to that

598

section, to read:

599

     429.11  Initial application for license; provisional

600

license.--

601

     (1) Each applicant for licensure must comply with all

602

provisions of part II of chapter 408 and must:

603

     (a) Identify all affiliates other homes or facilities,

604

including the addresses and the license or licenses under which

605

they operate, if applicable, which are currently operated by the

606

applicant or administrator and which provide housing, meals, and

607

personal services to residents.

608

     (b)  Provide the location of the facility for which a

609

license is sought and documentation, signed by the appropriate

610

local government official, which states that the applicant has

611

met local zoning requirements.

612

     (c)  Provide the name, address, date of birth, social

613

security number, education, and experience of the administrator,

614

if different from the applicant.

615

     (d) Provide a signed affidavit disclosing any affiliates

616

other than those identified in paragraph (a), controlling

617

entities, and entities having a controlling financial interest.

618

     (e) Provide any contracts with an affiliate or controlling

619

entity, including details of services provided and the intended

620

payment for those services.

621

     (f) Provide copies of any audits, investigations, or fines

622

related to the receipt or use of federal or state funds by all

623

affiliates, controlling entities, and entities having a

624

controlling financial interest. This includes the results of any

625

ongoing investigations into Medicaid or Medicare fraud or

626

Medicaid or Medicare overpayment, any standing corporate

627

integrity agreements, or other remedial action by any public

628

entity.

629

     (8) As a condition of licensure, license renewal, or change

630

of ownership, the licensee must agree to provide to the agency a

631

signed affidavit disclosing any financial or ownership interest

632

that an affiliate, a controlling entity, or an entity having a

633

controlling financial interest acquires within 30 days after the

634

acquisition.

635

     Section 11.  Section 429.12, Florida Statutes, is amended to

636

read:

637

     429.12  Sale or transfer of ownership of a facility.--It is

638

the intent of the Legislature to protect the rights of the

639

residents of an assisted living facility when the facility is

640

sold or the ownership thereof is transferred. Therefore, in

641

addition to the requirements of part II of chapter 408:

642

     (1) Within 5 days after submitting a request to the agency

643

for a change of ownership, the licensee shall notify all

644

residents and post the request in a sufficient number of

645

prominent locations in the assisted living facility and on the

646

primary Internet site of the facility in order for such

647

information to be accessible to all residents and to the public.

648

     (2) Affected parties, including, but not limited to, a

649

resident, a resident's family member, a resident's legal

650

representative, a resident's guardian, and facility staff may

651

submit information for the agency to consider in evaluating the

652

proposed owner's character, experience, background,

653

qualifications, and fitness for the license when determining

654

whether to grant a change of ownership.

655

     (3) The agency may propound any reasonable interrogatories

656

in addition to those contained in the request, or conduct further

657

investigations as necessary for the protection of the public and

658

to ascertain the proposed owner's character, experience,

659

background, qualifications, and fitness for the license.,

660

whenever a facility is sold or the ownership thereof is

661

transferred, including leasing:

662

     (1) The transferee shall notify the residents, in writing,

663

of the change of ownership within 7 days after receipt of the new

664

license.

665

     (4)(2) The transferor of a facility, the license of which

666

is denied pending an administrative hearing, shall, as a part of

667

the written change-of-ownership contract, advise the transferee

668

that a plan of correction must be submitted by the transferee and

669

approved by the agency at least 7 days before the change of

670

ownership and that failure to correct the condition that which

671

resulted in the moratorium pursuant to part II of chapter 408 or

672

denial of licensure is grounds for denial of the transferee's

673

license.

674

     (5) If the facility is sold, the ownership is transferred,

675

or the facility is leased, the transferee shall notify the

676

residents, in writing, of the change of ownership within 7 days

677

after receipt of the new license.

678

     (6) Upon granting a change of ownership, the new licensee

679

assumes all liabilities relative to prior licensees and

680

affiliates and controlling entities of the prior licensee.

681

     Section 12.  Paragraph (m) is added to subsection (1) of

682

section 429.14, Florida Statutes, and subsections (3) and (7) of

683

that section are amended, to read:

684

     429.14  Administrative penalties.--

685

     (1)  In addition to the requirements of part II of chapter

686

408, the agency may deny, revoke, and suspend any license issued

687

under this part and impose an administrative fine in the manner

688

provided in chapter 120 against a licensee of an assisted living

689

facility for a violation of any provision of this part, part II

690

of chapter 408, or applicable rules, or for any of the following

691

actions by a licensee of an assisted living facility, for the

692

actions of any person subject to level 2 background screening

693

under s. 408.809, or for the actions of any facility employee:

694

     (m) Failure to disclose at the time of licensure, license

695

renewal, or change of ownership all affiliates, controlling

696

entities, and entities having a controlling financial interest.

697

     (3) The agency may deny a license to any applicant who or

698

controlling interest as defined in part II of chapter 408 which

699

has or had a 25-percent or greater controlling financial or

700

ownership interest in any other facility licensed under this part

701

or in an affiliate of such a facility, or in any entity licensed

702

by this state or another state to provide health or residential

703

care, which facility or entity during the 5 years prior to the

704

application for a license closed due to financial inability to

705

operate; had a receiver appointed or a license denied, suspended,

706

or revoked; was subject to a moratorium; or had an injunctive

707

proceeding initiated against it.

708

     (7)  Agency notification of a license suspension or

709

revocation, or denial of a license renewal, or issuance of a

710

conditional license regardless of an administrative or judicial

711

challenge, must shall be posted and visible to the public at the

712

facility.

713

     Section 13.  Subsection (3) of section 429.275, Florida

714

Statutes, is amended to read:

715

     429.275  Business practice; personnel records; liability

716

insurance.--The assisted living facility shall be administered on

717

a sound financial basis that is consistent with good business

718

practices.

719

     (3)  The administrator or owner of a facility shall maintain

720

liability insurance coverage that is in force at all times. The

721

liability insurance may not be used for the litigation costs or

722

attorney's fees for the defense of a claim against the facility

723

pursuant to common law, s. 429.29, or s. 429.293.

724

     Section 14.  Section 429.174, Florida Statutes, is amended

725

to read:

726

     429.174  Background screening; exemptions.--The owner or

727

administrator of an assisted living facility must conduct level 1

728

background screening, as set forth in chapter 435, on all

729

employees hired on or after October 1, 1998, who perform personal

730

services as defined in s. 429.02(16). The agency may exempt an

731

individual from employment disqualification as set forth in

732

chapter 435. Such persons shall be considered as having met this

733

requirement if:

734

     (1) Proof of compliance with level 1 screening requirements

735

obtained to meet any professional license requirements in this

736

state is provided and accompanied, under penalty of perjury, by a

737

copy of the person's current professional license and an

738

affidavit of current compliance with the background screening

739

requirements.

740

     (2) The person required to be screened has been

741

continuously employed in the same type of occupation for which

742

the person is seeking employment without a breach in service

743

which exceeds 180 days, and proof of compliance with the level 1

744

screening requirement which is no more than 2 years old is

745

provided. Proof of compliance shall be provided directly from one

746

employer or contractor to another, and not from the person

747

screened. Upon request, a copy of screening results shall be

748

provided by the employer retaining documentation of the screening

749

to the person screened.

750

     (3) The person required to be screened is employed by a

751

corporation or business entity or related corporation or business

752

entity that owns, operates, or manages more than one facility or

753

agency licensed under this chapter, and for whom a level 1

754

screening was conducted by the corporation or business entity as

755

a condition of initial or continued employment.

756

     Section 15.  This act shall take effect July 1, 2008.

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

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