1 | A bill to be entitled |
2 | An act relating to nursing home litigation reform; |
3 | amending s. 400.023, F.S.; specifying conditions under |
4 | which a nursing home resident has a cause of action |
5 | against a licensee or management company; requiring the |
6 | trial judge to conduct an evidentiary hearing before a |
7 | claimant can assert a claim against certain interested |
8 | parties; providing a timeframe for a claimant to elect |
9 | survival damages or wrongful death damages; providing a |
10 | limitation on recovery; amending s. 400.0237, F.S.; |
11 | requiring evidence of the basis for punitive damages; |
12 | requiring the trial judge to conduct an evidentiary |
13 | hearing before a claimant can assert a claim for punitive |
14 | damages; permitting a licensee or management company to be |
15 | held liable for punitive damages under certain |
16 | circumstances; providing criteria for awarding of punitive |
17 | damages in a case of vicarious liability of certain |
18 | entities; amending s. 400.0238, F.S.; providing additional |
19 | conditions for settlements involving claims for punitive |
20 | damages; amending s. 400.23, F.S.; providing for a |
21 | rebuttable presumption in certain actions brought against |
22 | a licensee; providing limitations for admissibility of |
23 | survey and licensure reports and the presentation of |
24 | testimony or other evidence of staffing deficiencies; |
25 | providing applicability; providing an effective date. |
26 |
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27 | Be It Enacted by the Legislature of the State of Florida: |
28 |
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29 | Section 1. Section 400.023, Florida Statutes, is amended |
30 | to read: |
31 | 400.023 Civil enforcement.- |
32 | (1) Any resident who alleges negligence or a violation of |
33 | whose rights as specified in this part has are violated shall |
34 | have a cause of action against the licensee or its management |
35 | company, as specifically identified in the application for |
36 | nursing home licensure, and its direct caregiver employees. |
37 | Sections 400.023-400.0238 provide the exclusive remedy against a |
38 | licensee or management company for a cause of action for |
39 | recovery of damages for the personal injury or death of a |
40 | nursing home resident arising out of negligence or a violation |
41 | of residents' rights specified in s. 400.022. |
42 | (2) A cause of action may not be asserted individually |
43 | against an officer, director, owner, including any designated as |
44 | having a "controlling interest" on the application for nursing |
45 | home licensure, or agent of a licensee or management company |
46 | under this part unless, following an evidentiary hearing, the |
47 | court determines there is sufficient evidence in the record or |
48 | proffered by the claimant that establishes a reasonable basis |
49 | for a finding that: |
50 | (a) The officer, director, owner, or agent breached, |
51 | failed to perform, or acted outside the scope of duties as an |
52 | officer, director, owner, or agent; and |
53 | (b) The breach, failure to perform, or conduct outside the |
54 | scope of duties is a legal cause of actual loss, injury, death, |
55 | or damage to the resident. |
56 | (3) If an action is brought by or on behalf of a resident |
57 | under this part, a cause of action under s. 415.1111 may not be |
58 | asserted against an employee, officer, director, owner, or agent |
59 | of a licensee or management company. |
60 | (4) The action may be brought by the resident or his or |
61 | her guardian, by a person or organization acting on behalf of a |
62 | resident with the consent of the resident or his or her |
63 | guardian, or by the personal representative of the estate of a |
64 | deceased resident regardless of the cause of death. If the |
65 | action alleges a claim for the resident's rights or for |
66 | negligence that caused the death of the resident, the claimant |
67 | shall be required to elect, at the end of discovery but not |
68 | later than 60 days before trial, either survival damages |
69 | pursuant to s. 46.021 or wrongful death damages pursuant to s. |
70 | 768.21. In any claim for wrongful death brought under this |
71 | section, noneconomic damages may not exceed $250,000 per |
72 | resident, regardless of the number of claimants or defendants. |
73 | (5) If the action alleges a claim for the resident's |
74 | rights or for negligence that did not cause the death of the |
75 | resident, the personal representative of the estate may recover |
76 | damages for the negligence that caused injury to the resident. |
77 | The action may be brought in any court of competent jurisdiction |
78 | to enforce such rights and to recover actual and punitive |
79 | damages for any violation of the rights of a resident or for |
80 | negligence. |
81 | (6) Any resident who prevails in seeking injunctive relief |
82 | or a claim for an administrative remedy may is entitled to |
83 | recover the costs of the action, and a reasonable attorney's fee |
84 | assessed against the defendant not to exceed $25,000. Fees shall |
85 | be awarded solely for the injunctive or administrative relief |
86 | and not for any claim or action for damages whether such claim |
87 | or action is brought together with a request for an injunction |
88 | or administrative relief or as a separate action, except as |
89 | provided under s. 768.79 or the Florida Rules of Civil |
90 | Procedure. Sections 400.023-400.0238 provide the exclusive |
91 | remedy for a cause of action for recovery of damages for the |
92 | personal injury or death of a nursing home resident arising out |
93 | of negligence or a violation of rights specified in s. 400.022. |
94 | This section does not preclude theories of recovery not arising |
95 | out of negligence or s. 400.022 which are available to a |
96 | resident or to the agency. The provisions of Chapter 766 does do |
97 | not apply to any cause of action brought under ss. 400.023- |
98 | 400.0238. |
99 | (7)(2) In any claim brought under pursuant to this part |
100 | alleging a violation of resident's rights or negligence causing |
101 | injury to or the death of a resident, the claimant has shall |
102 | have the burden of proving, by a preponderance of the evidence, |
103 | that: |
104 | (a) The defendant breached the applicable standard of |
105 | care; and owed a duty to the resident; |
106 | (b) The defendant breached the duty to the resident; |
107 | (b)(c) The breach of the duty is a legal cause of actual |
108 | loss, injury, death, or damage to the resident; and |
109 | (d) The resident sustained loss, injury, death, or damage |
110 | as a result of the breach. |
111 | (8) Nothing in this part shall be interpreted to create |
112 | strict liability. A violation of the rights set forth in s. |
113 | 400.022 or in any other standard or guidelines specified in this |
114 | part or in any applicable administrative standard or guidelines |
115 | of this state or a federal regulatory agency shall be evidence |
116 | of negligence but shall not be considered negligence per se. |
117 | (9)(3) In any claim brought pursuant to this section, a |
118 | licensee, person, or entity shall have a duty to exercise |
119 | reasonable care. Reasonable care is that degree of care which a |
120 | reasonably careful licensee, person, or entity would use under |
121 | like circumstances. |
122 | (10)(4) In any claim for resident's rights violation or |
123 | negligence by a nurse licensed under part I of chapter 464, such |
124 | nurse shall have the duty to exercise care consistent with the |
125 | prevailing professional standard of care for a nurse. The |
126 | prevailing professional standard of care for a nurse shall be |
127 | that level of care, skill, and treatment which, in light of all |
128 | relevant surrounding circumstances, is recognized as acceptable |
129 | and appropriate by reasonably prudent similar nurses. |
130 | (11)(5) A licensee shall not be liable for the medical |
131 | negligence of any physician rendering care or treatment to the |
132 | resident except for the administrative services of a medical |
133 | director as required in this part. Nothing in this subsection |
134 | shall be construed to protect a licensee, person, or entity from |
135 | liability for failure to provide a resident with appropriate |
136 | observation, assessment, nursing diagnosis, planning, |
137 | intervention, and evaluation of care by nursing staff. |
138 | (12)(6) The resident or the resident's legal |
139 | representative shall serve a copy of any complaint alleging in |
140 | whole or in part a violation of any rights specified in this |
141 | part to the Agency for Health Care Administration at the time of |
142 | filing the initial complaint with the clerk of the court for the |
143 | county in which the action is pursued. The requirement of |
144 | providing a copy of the complaint to the agency does not impair |
145 | the resident's legal rights or ability to seek relief for his or |
146 | her claim. |
147 | (13)(7) An action under this part for a violation of |
148 | rights or negligence recognized herein is not a claim for |
149 | medical malpractice, and the provisions of s. 768.21(8) does do |
150 | not apply to a claim alleging death of the resident. |
151 | Section 2. Subsections (1), (2), and (3) of section |
152 | 400.0237, Florida Statutes, are amended to read: |
153 | 400.0237 Punitive damages; pleading; burden of proof.- |
154 | (1) In any action for damages brought under this part, a |
155 | no claim for punitive damages may not be brought shall be |
156 | permitted unless there is a reasonable showing of admissible by |
157 | evidence that has been in the record or proffered by the parties |
158 | and provides claimant which would provide a reasonable basis for |
159 | recovery of such damages when the criteria set forth in this |
160 | section are applied. The claimant may move to amend her or his |
161 | complaint to assert a claim for punitive damages as allowed by |
162 | the rules of civil procedure. The trial judge shall conduct an |
163 | evidentiary hearing and weigh the admissible evidence proffered |
164 | by all parties to ensure that there is a reasonable basis to |
165 | believe that the claimant, at trial, will be able to demonstrate |
166 | by clear and convincing evidence that the recovery of such |
167 | damages is warranted. The rules of civil procedure shall be |
168 | liberally construed so as to allow the claimant discovery of |
169 | evidence which appears reasonably calculated to lead to |
170 | admissible evidence on the issue of punitive damages. No A |
171 | discovery of financial worth may not shall proceed until after |
172 | the pleading on concerning punitive damages is approved |
173 | permitted. |
174 | (2) A defendant, including the licensee or management |
175 | company against whom punitive damages is sought, may be held |
176 | liable for punitive damages only if the trier of fact, based on |
177 | clear and convincing evidence, finds that a specific individual |
178 | or corporate defendant actively and knowingly participated in |
179 | intentional misconduct or engaged in conduct that constituted |
180 | gross negligence and contributed to the loss, damages, or injury |
181 | suffered by the claimant the defendant was personally guilty of |
182 | intentional misconduct or gross negligence. As used in this |
183 | section, the term: |
184 | (a) "Intentional misconduct" means that the defendant |
185 | against whom punitive damages are sought had actual knowledge of |
186 | the wrongfulness of the conduct and the high probability that |
187 | injury or damage to the claimant would result and, despite that |
188 | knowledge, intentionally pursued that course of conduct, |
189 | resulting in injury or damage. |
190 | (b) "Gross negligence" means that the defendant's conduct |
191 | was so reckless or wanting in care that it constituted a |
192 | conscious disregard or indifference to the life, safety, or |
193 | rights of persons exposed to such conduct. |
194 | (3) In the case of vicarious liability of an employer, |
195 | principal, corporation, or other legal entity, punitive damages |
196 | may not be imposed for the conduct of an employee or agent |
197 | unless only if the conduct of a specifically identified the |
198 | employee or agent meets the criteria specified in subsection (2) |
199 | and an officer, director, or manager of the actual employer, |
200 | corporation, or legal entity condoned, ratified, or consented to |
201 | the specific conduct as alleged in subsection (2). A state or |
202 | federal survey report of nursing facilities may not be used to |
203 | establish an entitlement to punitive damages under this |
204 | section.: |
205 | (a) The employer, principal, corporation, or other legal |
206 | entity actively and knowingly participated in such conduct; |
207 | (b) The officers, directors, or managers of the employer, |
208 | principal, corporation, or other legal entity condoned, |
209 | ratified, or consented to such conduct; or |
210 | (c) The employer, principal, corporation, or other legal |
211 | entity engaged in conduct that constituted gross negligence and |
212 | that contributed to the loss, damages, or injury suffered by the |
213 | claimant. |
214 | Section 3. Subsections (2) and (4) of section 400.0238, |
215 | Florida Statutes, are amended to read: |
216 | 400.0238 Punitive damages; limitation.- |
217 | (2) The claimant's attorney's fees, if payable from the |
218 | judgment, are, to the extent that the fees are based on the |
219 | punitive damages, calculated based on the claimant's share of |
220 | final judgment for punitive damages. This subsection does not |
221 | limit the payment of attorney's fees based upon an award of |
222 | damages other than punitive damages. |
223 | (4) Notwithstanding any other law to the contrary, if a |
224 | claimant has received a final judgment for the amount of |
225 | punitive damages or there is a settlement of a case in which the |
226 | claimant was granted leave to amend his or her complaint to add |
227 | a claim for punitive damages, the punitive award awarded |
228 | pursuant to this section shall be equally divided, before any |
229 | distribution to the claimant's counsel for fees or costs, |
230 | between the claimant and the Quality of Long-Term Care Facility |
231 | Improvement Trust Fund, in accordance with the following |
232 | provisions: |
233 | (a) In the event of a judgment, the clerk of the court |
234 | shall transmit a copy of the jury verdict to the Chief Financial |
235 | Officer by certified mail. In the final judgment, the court |
236 | shall order the percentages of the award, payable as provided |
237 | herein. In the event of a settlement, the parties shall transmit |
238 | by certified mail to the Chief Financial Officer a statement of |
239 | the proportionate share due to the Quality of Long-Term Care |
240 | Facility Improvement Trust Fund. |
241 | (b) A settlement agreement entered into between the |
242 | original parties to the action after a verdict has been returned |
243 | must provide a proportionate share payable to the Quality of |
244 | Long-Term Care Facility Improvement Trust Fund specified herein. |
245 | For purposes of this paragraph, a proportionate share is a 50- |
246 | percent share of that percentage of the settlement amount which |
247 | the punitive damages portion of the verdict bore to the total of |
248 | the compensatory and punitive damages in the verdict. |
249 | (c) For a settlement agreement entered into between the |
250 | parties to the action, at any time after a claimant is permitted |
251 | by the court to amend the complaint to add a count for punitive |
252 | damages, but before a final judgment on the issue, 50 percent of |
253 | the total settlement amount shall be the punitive award. The |
254 | punitive award shall be equally divided, before any distribution |
255 | to the claimant's counsel for fees or costs, between the |
256 | claimant and the Quality of Long-Term Care Facility Improvement |
257 | Trust Fund. The amount of the punitive award and the allocation |
258 | of that award provided for in this subsection may not be altered |
259 | in any way by agreement of the parties after the claimant has |
260 | been granted leave to amend his or her complaint to include a |
261 | claim for punitive damages. |
262 | (d) Settlement of a claim before a verdict by a defendant |
263 | in which a claimant was permitted at any time to amend the claim |
264 | to add a count for punitive damages is not an admission or |
265 | finding of liability for conduct described in subsection (2). |
266 | (e)(c) The Department of Financial Services shall collect |
267 | or cause to be collected all payments due the state under this |
268 | section. Such payments are made to the Chief Financial Officer |
269 | and deposited in the appropriate fund specified in this |
270 | subsection. |
271 | (f)(d) If the full amount of punitive damages awarded |
272 | cannot be collected, the claimant and the other recipient |
273 | designated pursuant to this subsection are each entitled to a |
274 | proportionate share of the punitive damages collected. |
275 | Section 4. Paragraph (d) is added to subsection (3) and |
276 | paragraph (e) is added to subsection (8) of section 400.23, |
277 | Florida Statutes, to read: |
278 | 400.23 Rules; evaluation and deficiencies; licensure |
279 | status.- |
280 | (3) |
281 | (d) In any action brought under ss. 400.023-400.0238, if |
282 | the licensee demonstrates compliance with the minimum staffing |
283 | requirements under this part, the licensee is entitled to a |
284 | rebuttable presumption that appropriate staffing was provided. |
285 | (8) The agency shall adopt rules pursuant to this part and |
286 | part II of chapter 408 to provide that, when the criteria |
287 | established under subsection (2) are not met, such deficiencies |
288 | shall be classified according to the nature and the scope of the |
289 | deficiency. The scope shall be cited as isolated, patterned, or |
290 | widespread. An isolated deficiency is a deficiency affecting one |
291 | or a very limited number of residents, or involving one or a |
292 | very limited number of staff, or a situation that occurred only |
293 | occasionally or in a very limited number of locations. A |
294 | patterned deficiency is a deficiency where more than a very |
295 | limited number of residents are affected, or more than a very |
296 | limited number of staff are involved, or the situation has |
297 | occurred in several locations, or the same resident or residents |
298 | have been affected by repeated occurrences of the same deficient |
299 | practice but the effect of the deficient practice is not found |
300 | to be pervasive throughout the facility. A widespread deficiency |
301 | is a deficiency in which the problems causing the deficiency are |
302 | pervasive in the facility or represent systemic failure that has |
303 | affected or has the potential to affect a large portion of the |
304 | facility's residents. The agency shall indicate the |
305 | classification on the face of the notice of deficiencies as |
306 | follows: |
307 | (e) A deficiency identified by the agency in a nursing |
308 | home survey is not admissible for any purpose in an action under |
309 | ss. 400.023-400.0238. However, a survey deficiency citing a |
310 | resident on whose behalf the action is brought may be introduced |
311 | as evidence of negligence if the agency has determined that the |
312 | resident sustained actual harm as a result thereof. If a |
313 | claimant in an action under ss. 400.023-400.0238 was a member of |
314 | a survey resident roster or otherwise was the subject of any |
315 | survey by the agency and the agency did not allege or determine |
316 | that any deficiency occurred with respect to that claimant |
317 | during that survey, the licensee may introduce the absence of a |
318 | deficiency citation to refute an allegation of neglect or |
319 | noncompliance with regulatory standards. |
320 | Section 5. This act shall take effect July 1, 2011, and |
321 | shall apply to all causes of action that accrue on or after that |
322 | date. |