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Florida Senate - 2008 COMMITTEE AMENDMENT

Bill No. SB 1668

756332

CHAMBER ACTION

Senate

Comm: RCS

4/15/2008

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House



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The Committee on Health Regulation (Jones) recommended the

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following amendment:

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     Senate Amendment (with title amendment)

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     Delete everything after the enacting clause

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and insert:

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     Section 1. This act may be cited as the "Long-Term Care

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Transparency Act."

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     Section 2.  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

18

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 the facility's budget, staffing levels, setting or

33

monitoring census goals, employment decisions, capital purchases,

34

facility improvements, plant improvements, access to or use of

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the facility's assets or equipment, financing or lending

36

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,

47

association, joint venture, company, sole proprietorship,

48

corporation, limited liability corporation, professional limited

49

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

52

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

55

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

56

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

57

reason of illness, physical infirmity, or advanced age require

58

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

66

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.

69

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

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responsibility for hiring the administrator and for approving a

71

facility's policies and procedures and ensuring their proper

72

implementation.

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     Section 3.  Paragraph (h) is added to subsection (2) of

74

section 400.0239, Florida Statutes, to read:

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     400.0239  Quality of Long-Term Care Facility Improvement

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Trust Fund.--

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     (2)  Expenditures from the trust fund shall be allowable for

78

direct support of the following:

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     (h) The development and expansion of an electronic Nursing

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Home Guide pursuant to s. 400.191 to aid prospective residents in

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selecting a nursing facility that will meet their unique needs

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and standards.

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     Section 4.  Subsection (1) of section 400.071, Florida

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Statutes, is amended, present subsections (2) through (5) of that

85

section are renumbered as subsections (3) through (6),

86

respectively, and new subsection (2) is added to that section, to

87

read:

88

     400.071  Application for license.--

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

90

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

91

under oath and must contain the following:

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

93

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

94

the such location conforms to the local zoning ordinances.

95

     (b)  A signed affidavit disclosing any financial or

96

ownership interest that the applicant, an affiliate, a

97

controlling entity, or an entity having a controlling financial

98

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

99

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

101

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

102

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

103

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

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initiated by a regulatory agency. The affidavit must disclose the

105

reason the any such entity was closed, whether voluntarily or

106

involuntarily.

107

     (c) A signed affidavit disclosing any affiliate of,

108

controlling entity of, and entity having a controlling financial

109

interest in the applicant.

110

     (d) The total number of beds and the total number of

111

Medicare and Medicaid certified beds.

112

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

113

which the agency requires by rule. The applicant must demonstrate

114

that sufficient numbers of qualified staff, by training or

115

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

116

number of residents who will reside in the facility.

117

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

118

must demonstrate an ability to provide staff at required levels

119

and maintain solvency in accordance with this part, applicable

120

provisions of chapter 408, and related rules. Documentation must

121

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

122

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

123

of operation, a statement of projected revenues and expenses for

124

the first 12 months of operation following licensure, a detailed

125

explanation of the assumptions implicit in these projections, the

126

basis for financing the applicant's anticipated cash-flow

127

requirements, and the applicant's access to contingency

128

financing. This information is not required for a routine license

129

renewal.

130

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

131

the applicant, affiliates, or controlling entities rendered

132

within the 10 years preceding the application, relating to

133

medical negligence, violation of residents' rights, or wrongful

134

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

135

provide to the agency copies of any new verdict or judgment

136

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

137

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

138

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

139

licensure file and in an agency database that which is available

140

as a public record.

141

     (h) Copies of any contracts with affiliates or controlling

142

entities, including details of goods or services provided and the

143

intended method of payment for those goods and services.

144

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

145

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

146

affiliates, controlling entities, and entities having a

147

controlling financial interest. These include the results of or

148

any ongoing investigations into Medicaid or Medicare fraud or

149

Medicaid or Medicare overpayment, any standing corporate

150

integrity agreements, or other remedial action by a public

151

entity.

152

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

153

applicant's governing body.

154

     (2) Information relating to financial and ownership

155

information shall be submitted in a format prescribed by the

156

agency.

157

     Section 5.  Section 400.102, Florida Statutes, is amended to

158

read:

159

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

160

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

161

the following conditions shall be grounds for action by the

162

agency against a licensee:

163

     (1)  An intentional or negligent act materially affecting

164

the health or safety of residents of the facility.;

165

     (2)  Misappropriation or conversion of the property of a

166

resident of the facility.;

167

     (3)  Failure to follow the criteria and procedures provided

168

under part I of chapter 394 relating to the transportation,

169

voluntary admission, and involuntary examination of a nursing

170

home resident.; or

171

     (4)  Fraudulent altering, defacing, or falsifying any

172

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

173

these offenses to be committed.

174

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

175

renewal, or change of ownership all affiliates, controlling

176

entities, entities having a controlling financial interest, or

177

members of the facility's governing body.

178

     Section 6.  Section 400.111, Florida Statutes, is amended to

179

read:

180

     400.111  Disclosure of controlling interest.--In addition to

181

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

182

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

183

submit a signed affidavit disclosing any financial or ownership

184

interest that an affiliate, controlling entity, or entity having

185

a controlling financial interest has held within the last 5 years

186

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

187

health or residential care which entity has closed voluntarily or

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involuntarily; has filed for bankruptcy; has had a receiver

189

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

190

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,

194

the licensee must agree to provide to the agency a signed

195

affidavit disclosing such interest within 30 days after the

196

acquisition.

197

     Section 7.  Subsections (1) and (3) of section 400.121,

198

Florida Statutes, are amended to read:

199

     400.121  Denial, suspension, revocation of license;

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

201

     (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

205

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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223

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 any 30-month period;

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     (b)  Is conditionally licensed for 180 or more continuous

235

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.

241

242

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 8.  Subsection (20) of section 400.141, Florida

247

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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     (20)  Maintain general and professional liability insurance

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coverage that is in force at all times. The insurance may not be

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used for the litigation costs or attorney's fees for the defense

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of a claim against a nursing home pursuant to the common law, s.

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400.023, or s. 400.0233. The licensee must notify the agency

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immediately if the policy limits or annual aggregate liability

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coverage has been exhausted. In lieu of general and professional

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liability insurance coverage, a state-designated teaching nursing

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home and its affiliated assisted living facilities created under

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s. 430.80 may demonstrate proof of financial responsibility as

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provided in s. 430.80(3)(h).

262

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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 9.  Effective December 1, 2008, subsections (2) and

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(5) of section 400.191, Florida Statutes, are amended to read:

270

     400.191  Availability, distribution, and posting of reports

271

and records.--

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     (2) The agency shall maintain an electronic publish the

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Nursing Home Guide annually in a consumer-friendly printed form

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and quarterly in electronic form, which is updated weekly, to

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assist consumers and their families in comparing and evaluating

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nursing home facilities.

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     (a) The agency shall provide an Internet website that, at a

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minimum, includes site which shall include at least the following

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information either directly or indirectly through a link to other

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another established websites 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

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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

286

nursing homes and how to obtain additional information regarding

287

these alternatives. The Nursing Home Guide shall explain that

288

this state offers alternative programs that allow permit

289

qualified elderly persons to stay in their homes instead of being

290

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-

294

based programs and which shall clearly state the services that

295

are provided and indicate whether nursing home services are

296

included if needed.

297

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

298

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

299

facility was known during the previous 24-month period.

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

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entities having a controlling financial interest that are

302

affiliated with or associated with the facility.

303

     4. Any documents related to audits, investigations, or

304

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

305

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

306

having a controlling financial interest, including all related

307

documents submitted under s. 400.071.

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     5.3. Whether the facility is such nursing home facilities

309

are proprietary or nonproprietary.

310

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

311

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

312

license.

313

     7.5. The name of the owner or owners of the each facility

314

and whether the facility is affiliated with a company or other

315

organization owning or managing more than one nursing facility in

316

this state.

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     8.6. The total number of beds in the each facility and the

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most recently available occupancy levels.

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     9.7. The number of private and semiprivate rooms in the

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each facility.

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     10.8. The religious affiliation, if any, of the each

322

facility.

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     11.9. The languages spoken by the administrator and staff

324

of the each facility.

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     12.10. Whether the or not each facility accepts Medicare or

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Medicaid recipients or insurance, health maintenance

327

organization, Veterans Administration, CHAMPUS program, or

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workers' compensation coverage.

329

     13.11. Recreational programs, special care units, and other

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programs available at the each facility.

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     14.12. Special care units or programs offered at the each

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facility.

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     15.13. Whether the facility is a part of a retirement

334

community that offers other services pursuant to part III of this

335

chapter or part I or part III of chapter 429.

336

     16.14. Survey and deficiency information, including all

337

federal and state recertification, licensure, revisit, and

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complaint survey information, for the each facility for the past

339

30 months. For noncertified nursing homes, state survey and

340

deficiency information, including licensure, revisit, and

341

complaint survey information for the past 30 months shall be

342

provided.

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     17.15. A summary of the deficiency data for the each

344

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

345

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

346

facilities based on the number of citations received by the

347

facility on recertification, licensure, revisit, and complaint

348

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

349

of recertification surveys the facility has had during the past

350

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

351

presented in either numeric or symbolic form for the intended

352

consumer audience.

353

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

354

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

355

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

356

facilities that have submitted an application for a change of

357

ownership, including the date of the submission and current

358

status of that application.

359

     (b) The agency shall provide the following information in

360

printed form:

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     1. A section entitled "Have you considered programs that

362

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

363

first section of the Nursing Home guide and which shall

364

prominently display information about available alternatives to

365

nursing homes and how to obtain additional information regarding

366

these alternatives. The Nursing Home guide shall explain that

367

this state offers alternative programs that permit qualified

368

elderly persons to stay in their homes instead of being placed in

369

nursing homes and shall encourage interested persons to call the

370

Comprehensive Assessment Review and Evaluation for Long-Term Care

371

Services (CARES) Program to inquire if they qualify. The Nursing

372

Home guide shall list available home and community-based programs

373

which shall clearly state the services that are provided and

374

indicate whether nursing home services are included if needed.

375

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

376

facilities in this state.

377

     3. Whether the nursing home facilities are proprietary or

378

nonproprietary.

379

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

380

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

381

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

382

rooms, in each facility.

383

     6. The religious affiliation, if any, of each facility.

384

     7. The name of the owner of each facility and whether the

385

facility is affiliated with a company or other organization

386

owning or managing more than one nursing facility in this state.

387

     8. The languages spoken by the administrator and staff of

388

each facility.

389

     9. Whether or not each facility accepts Medicare or

390

Medicaid recipients or insurance, health maintenance

391

organization, Veterans Administration, CHAMPUS program, or

392

workers' compensation coverage.

393

     10. Recreational programs, special care units, and other

394

programs available at each facility.

395

     11. The Internet address for the site where more detailed

396

information can be seen.

397

     12. A statement advising consumers that each facility will

398

have its own policies and procedures related to protecting

399

resident property.

400

     13. A summary of the deficiency data for each facility over

401

the past 30 months. The summary may include a score, rating, or

402

comparison ranking with respect to other facilities based on the

403

number of citations received by the facility on recertification,

404

licensure, revisit, and complaint surveys; the severity and scope

405

of the citations; the number of citations; and the number of

406

recertification surveys the facility has had during the past 30

407

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

408

in either numeric or symbolic form for the intended consumer

409

audience.

410

     (b)(c) The agency shall may provide the following

411

additional information on its an Internet website site or in

412

printed form as the information becomes available:

413

     1.  The licensure status history of each facility.

414

     2.  The rating history of each facility.

415

     3.  The regulatory history of each facility, which may

416

include federal sanctions, state sanctions, federal fines, state

417

fines, and other actions.

418

     4.  Whether the facility currently possesses the Gold Seal

419

designation awarded pursuant to s. 400.235.

420

     5. Known Internet links to the websites Internet sites of

421

the facilities, or their affiliates, controlling entities, and

422

entities having a controlling financial interest.

423

     (5)  Every nursing home facility licensee shall:

424

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

425

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

426

residents and to the general public:

427

     1.  A concise summary of the last inspection report

428

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

429

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

430

deficiencies found by the agency and the actions taken by the

431

licensee to rectify the deficiencies and indicating in the

432

summaries where the full reports may be inspected in the nursing

433

home.

434

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

435

most recent version of the Nursing Home Guide.

436

     3. A copy of any conditional license in effect regardless

437

of an administrative or judicial challenge for the purpose of

438

providing public transparency and timely notification.

439

     (b)  Upon request, provide to any person who has completed a

440

written application for admission with an intent to be admitted

441

to, or to a any resident of, a nursing home, or to any relative,

442

spouse, surrogate, or guardian of the person, a copy of the

443

nursing home's last inspection report or a printed copy of the

444

Nursing Home Guide if pertaining to the nursing home and issued

445

by the agency, provided the person requesting the report agrees

446

to pay a reasonable charge to cover copying costs.

447

     Section 10.  Section 400.197, Florida Statutes, is created

448

to read:

449

     400.197 Change of ownership.--

450

     (1) Within 5 days after a licensee submits a request for a

451

change of ownership to the agency, the licensee shall notify all

452

residents of the request in writing and post that information in

453

a sufficient number of prominent locations in the nursing home

454

facility and on the primary Internet website of the nursing home

455

and its controlling entities so that the information is

456

accessible to all residents and the public.

457

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

458

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

459

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

460

submit information for the agency to consider when evaluating the

461

proposed owner's character, experience, background,

462

qualifications, and fitness for licensure when determining

463

whether to grant a change of ownership.

464

     (3) The agency may propound any reasonable interrogatories

465

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

466

investigations as necessary for the protection of the public and

467

to ascertain the proposed owner's character, experience,

468

background, qualifications, and fitness for licensure.

469

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

470

assumes all liabilities of the prior licensee, its affiliates, or

471

controlling entities relating to or arising out of the operation

472

of the facility and services provided at the facility under the

473

prior licensee.

474

     Section 11.  Subsections (3) though (26) of section 429.02,

475

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

476

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

477

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

478

section are amended, to read:

479

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

480

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

481

owners, officers, board members, directors, limited liability

482

corporation members, operating company, management company, or

483

address as an assisted living facility.

484

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

485

Administration.

486

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

487

of providing increased or adjusted services to a person to

488

compensate for the physical or mental decline that may occur with

489

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

490

independence and allow permit them to remain in a familiar,

491

noninstitutional, residential environment for as long as

492

possible. Such services may be provided by facility staff,

493

volunteers, family, or friends, or through contractual

494

arrangements with a third party.

495

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

496

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

497

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

498

whether operated for profit or not, which undertakes through its

499

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

500

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

501

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

502

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

503

physically limits, restricts, or deprives an individual of

504

movement or mobility, and is used for discipline or convenience

505

and not required for the treatment of medical symptoms.

506

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

507

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

508

mental health case manager in consultation with the administrator

509

of an assisted living facility with a limited mental health

510

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

511

to the administrator. The plan must include information about the

512

supports, services, and special needs of the resident which

513

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

514

method by which facility staff can recognize and respond to the

515

signs and symptoms particular to that resident which indicate the

516

need for professional services.

517

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

518

control over an assisted living facility, including, but not

519

limited to, control over the facility's budget, staffing levels,

520

setting or monitoring census goals, employment decisions, capital

521

purchases, facility improvements, plant improvements, access to

522

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

523

lending agreements, or the business decisions of the facility.

524

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

525

percent or greater financial ownership interest in an assisted

526

living facility, an affiliate, or controlling entity.

527

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

528

of understanding between a mental health care provider and the

529

administrator of the assisted living facility with a limited

530

mental health license in which a mental health resident is

531

living. The agreement must specify directions for accessing

532

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

533

single cooperative agreement may service all mental health

534

residents who are clients of the same mental health care

535

provider.

536

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

537

Affairs.

538

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

539

or method of operation which presents imminent danger of death or

540

serious physical or mental harm to facility residents.

541

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

542

association, joint venture, company, sole proprietorship,

543

corporation, limited liability corporation, professional limited

544

liability corporation, or any other form of doing business.

545

     Section 12.  Subsection (1) of section 429.11, Florida

546

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

547

section, to read:

548

     429.11  Initial application for license; provisional

549

license.--

550

     (1) Each applicant for licensure must comply with all

551

provisions of part II of chapter 408 and must:

552

     (a) Identify all affiliates other homes or facilities,

553

including the addresses and the license or licenses under which

554

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

555

applicant or administrator and which provide housing, meals, and

556

personal services to residents.

557

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

558

license is sought and documentation, signed by the appropriate

559

local government official, which states that the applicant has

560

met local zoning requirements.

561

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

562

security number, education, and experience of the administrator,

563

if different from the applicant.

564

     (d) Provide a signed affidavit disclosing any affiliates,

565

controlling entities, and entities having a controlling financial

566

interest.

567

     (e) Provide copies of any contracts with an affiliate or

568

controlling entity, including details of goods and services

569

provided and the intended payment for those goods and services.

570

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

571

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

572

affiliates, controlling entities, and entities having a

573

controlling financial interest. This includes the results of any

574

ongoing investigations into Medicaid or Medicare fraud or

575

Medicaid or Medicare overpayment, any standing corporate

576

integrity agreements, or other remedial action by any public

577

entity.

578

     (g) Submit all information regarding financial and

579

ownership information in a format prescribed by the agency.

580

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

581

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

582

signed affidavit disclosing any financial or ownership interest

583

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

584

controlling financial interest acquires within 30 days after the

585

acquisition.

586

     Section 13.  Section 429.12, Florida Statutes, is amended to

587

read:

588

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

589

the intent of the Legislature to protect the rights of the

590

residents of an assisted living facility when the facility is

591

sold or the ownership thereof is transferred. Therefore, in

592

addition to the requirements of part II of chapter 408, whenever

593

a facility is sold or the ownership thereof is transferred,

594

including leasing:

595

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

596

for a change of ownership, the licensee shall notify all

597

residents of the request in writing and post that information in

598

a sufficient number of prominent locations in the assisted living

599

facility and on the primary Internet website of the facility so

600

that the information is accessible to all residents and the

601

public. The transferee shall notify the residents, in writing, of

602

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

603

license.

604

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

605

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

606

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

607

submit information for the agency to consider in evaluating the

608

proposed owner's character, experience, background,

609

qualifications, and fitness for the license when determining

610

whether to grant a change of ownership.

611

     (3) The agency may propound any reasonable interrogatories

612

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

613

investigations as necessary for the protection of the public and

614

to ascertain the proposed owner's character, experience,

615

background, qualifications, and fitness for licensure.

616

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

617

assumes all liabilities of the prior licensee, its affiliates, or

618

controlling entities relating to or arising out of the operation

619

of the facility and services provided at the facility under the

620

prior licensee.

621

     (5) Within 7 days after receipt of the new license, the

622

transferee shall notify the residents in writing of the change of

623

ownership.

624

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

625

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

626

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

627

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

628

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

629

ownership and that failure to correct the condition that which

630

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

631

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

632

license.

633

     Section 14.  Paragraph (m) is added to subsection (1) of

634

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

635

that section are amended, to read:

636

     429.14  Administrative penalties.--

637

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

638

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

639

under this part and impose an administrative fine in the manner

640

provided in chapter 120 against a licensee of an assisted living

641

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

642

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

643

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

644

actions of any person subject to level 2 background screening

645

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

646

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

647

renewal, or change of ownership all affiliates, controlling

648

entities, and entities having a controlling financial interest.

649

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

650

controlling interest as defined in part II of chapter 408 which

651

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

652

interest in any other facility licensed under this part, in any

653

affiliate or controlling entity, or in any entity licensed by

654

this state or another state to provide health or residential

655

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

656

application for a license closed due to financial inability to

657

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

658

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

659

proceeding initiated against it.

660

     (7)  Agency notification of a license suspension or

661

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

662

conditional license regardless of an administrative or judicial

663

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

664

facility.

665

     Section 15.  Section 429.174, Florida Statutes, is amended

666

to read:

667

     429.174  Background screening; exemptions.--The owner or

668

administrator of an assisted living facility must conduct level 1

669

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

670

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

671

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

672

individual from employment disqualification as set forth in

673

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

674

requirement if:

675

     (1) Proof of compliance with level 1 screening requirements

676

obtained to meet any professional license requirements in this

677

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

678

copy of the person's current professional license and an

679

affidavit of current compliance with the background screening

680

requirements.

681

     (2) The person required to be screened has been

682

continuously employed in the same type of occupation for which

683

the person is seeking employment without a breach in service

684

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

685

screening requirement which is no more than 2 years old is

686

provided. Proof of compliance shall be provided directly from one

687

employer or contractor to another, and not from the person

688

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

689

provided by the employer retaining documentation of the screening

690

to the person screened.

691

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

692

corporation or business entity or related corporation or business

693

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

694

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

695

screening was conducted by the corporation or business entity as

696

a condition of initial or continued employment.

697

     Section 16.  Subsection (3) of section 429.275, Florida

698

Statutes, is amended to read:

699

     429.275  Business practice; personnel records; liability

700

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

701

a sound financial basis that is consistent with good business

702

practices.

703

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

704

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

705

general and professional liability insurance may not be used for

706

the litigation costs or attorney's fees for the defense of a

707

claim against the facility pursuant to common law, s. 429.29, or

708

s. 429.293. The administrator or owner of a facility must notify

709

the agency immediately if the policy limits or annual aggregate

710

liability coverage has been exhausted.

711

     Section 17. Except as otherwise expressly provided in this

712

act, this act shall take effect July 1, 2008.

713

714

================ T I T L E  A M E N D M E N T ================

715

And the title is amended as follows:

716

     Delete everything before the enacting clause

717

and insert:

718

A bill to be entitled

719

An act relating to long-term care facilities; providing a

720

short title; amending s. 400.021, F.S.; revising

721

definitions relating to nursing homes; defining the terms

722

"affiliate," "controlling entity," "controlling financial

723

interest," "entity," and "governing body"; amending s.

724

400.0239, F.S.; authorizing the expenditure of funds from

725

the Quality of Long-Term Care Facility Improvement Trust

726

Fund for the development of an electronic Nursing Home

727

Guide; amending s. 400.071, F.S.; revising provisions

728

relating to nursing home license applications; requiring

729

the application to include the facility's affiliates,

730

controlling entities, and entities having a controlling

731

interest in the facility, proof of ability to operate,

732

copies of certain contracts and investigations and fines,

733

and the members of the facility's governing body;

734

requiring financial and ownership information to be

735

submitted in a format prescribed by the agency; amending

736

s. 400.102, F.S.; revising grounds for taking action

737

against a nursing home to conform to changes made by the

738

act; amending s. 400.111, F.S.; requiring the disclosure

739

of controlling interests at the time of licensure, license

740

renewal, or change of ownership; amending s. 400.121,

741

F.S.; revising provisions relating to the denial,

742

suspension, or revocation of a license to conform to

743

changes made by the act; amending s. 400.141, F.S.;

744

prohibiting nursing home liability insurance from paying

745

for certain legal costs; requiring the facility to notify

746

the agency if the policy has been exhausted; amending s.

747

400.191, F.S.; requiring that the Agency for Health Care

748

Administration to maintain an electronic Nursing Home

749

Guide; deleting the requirement that the agency provide a

750

printed guide; revising the information that must be

751

provided on the agency's website; creating s. 400.197,

752

F.S.; requiring a nursing home to notify residents and

753

post a request for a change of ownership in prominent

754

locations in the nursing home; providing for a hearing as

755

to the fitness of a new owner; providing for

756

investigations of the new owner; providing that a new

757

owner assumes the liabilities of the prior licensee, its

758

affiliates, or controlling entities; amending s. 429.02,

759

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

760

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

761

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

762

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

763

applications for an assisted living facility license;

764

requiring the application to include members of the

765

facilities governing body, the facility's affiliates,

766

controlling entities, and entities having a controlling

767

interest in the facility, and copies of certain contracts

768

and investigations and fines; requiring financial and

769

ownership information to be submitted in a format

770

prescribed by the agency; amending s. 429.12, F.S.;

771

requiring the assisted living facility to notify residents

772

and post a request for a change of ownership in prominent

773

locations in the facility; providing for a hearing as to

774

the fitness of a new owner upon request; providing for

775

investigations of the new owner; providing that a new

776

owner assumes the liabilities of the prior licensee,

777

affiliates, or controlling entities; amending s. 429.14,

778

F.S.; revising provisions relating to the denial,

779

suspension, or revocation of a license to conform to

780

changes made by the act; amending s. 429.174, F.S.;

781

conforming a cross-reference; amending s. 429.275, F.S.;

782

prohibiting assisted living facility liability insurance

783

from paying for certain legal costs; requiring the

784

facility to notify the agency if the policy has been

785

exhausted; providing effective dates.

3/31/2008  9:23:00 AM     13-06088-08

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

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