Bill Text: FL S0896 | 2018 | Regular Session | Introduced


Bill Title: Nursing Homes and Related Health Care Facilities

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2018-01-09 - Introduced [S0896 Detail]

Download: Florida-2018-S0896-Introduced.html
       Florida Senate - 2018                                     SB 896
       
       
        
       By Senator Farmer
       
       
       
       
       
       34-00537B-18                                           2018896__
    1                        A bill to be entitled                      
    2         An act relating to nursing homes and related health
    3         care facilities; creating s. 366.042, F.S.; requiring
    4         the Florida Public Service Commission to ensure that
    5         public utilities effectively prioritize the
    6         restoration of services to certain health care
    7         facilities in the event of emergencies; amending s.
    8         366.15, F.S.; deleting a provision specifying that
    9         noncompliance with certain provisions related to
   10         medically essential electric public utility service
   11         does not form the basis for a cause of action against
   12         a public utility; deleting a provision specifying that
   13         a public utility’s failure to comply with certain
   14         obligations does not constitute negligence; amending
   15         s. 400.0060, F.S.; defining the term “autonomy”;
   16         amending s. 400.0063, F.S.; establishing an Office of
   17         the State Long-Term Care Ombudsman within the
   18         Department of Elderly Affairs to administer the State
   19         Long-Term Care Ombudsman Program; requiring the office
   20         to contract with or make a grant to a private
   21         nonprofit organization to manage the day-to-day
   22         operations of the program; providing that the office
   23         is not responsible for the licensing or certification
   24         of long-term care facilities and prohibiting the
   25         office from having a relationship with any such
   26         facility; revising the appointment and removal
   27         processes for the state ombudsman; requiring the state
   28         ombudsman and the office’s legal advocate to register
   29         as lobbyists; expanding the duties of the legal
   30         advocate to include assisting the state ombudsman with
   31         certain tasks related to the autonomy of the program;
   32         amending s. 400.0065, F.S.; providing that a purpose
   33         of the State Long-Term Care Ombudsman Program is to
   34         support, rather than to administer, the state and
   35         local councils; revising requirements for the annual
   36         report required to be prepared by the State Long-Term
   37         Care Ombudsman; amending s. 400.0067, F.S.; revising
   38         the membership of the State Long-Term Care Ombudsman
   39         Council; revising the number of consecutive terms that
   40         may be served by the chair of the state council;
   41         amending s. 400.0069, F.S.; requiring each state long
   42         term care ombudsman district to convene a public
   43         meeting at least monthly, rather than quarterly;
   44         requiring representatives of the program, upon an
   45         affirmative vote of the state council, to comment on
   46         certain existing and proposed rules, regulations, and
   47         policies; amending s. 400.0073, F.S.; authorizing
   48         state and local councils to hold public hearings
   49         related to certain investigations; requiring the legal
   50         advocate to pursue legal remedies under certain
   51         circumstances; amending s. 400.0074, F.S.; requiring
   52         that onsite administrative assessments include the
   53         review of the facility’s emergency management plan;
   54         authorizing the office’s legal advocate to pursue
   55         legal remedies for certain violations; requiring,
   56         rather than authorizing, the department to adopt rules
   57         implementing procedures for conducting onsite
   58         administrative assessments of long-term care
   59         facilities; amending s. 400.0077, F.S.; specifying
   60         that the public discussion of administrative
   61         assessments before the council is open to the public
   62         and subject to ch. 119 and s. 286.011, F.S.; amending
   63         s. 400.0078, F.S.; requiring the State Long-Term Care
   64         Ombudsman Program to create and make available a
   65         poster that contains certain information; requiring
   66         each long-term care facility to display the State
   67         Long-Term Care Ombudsman Program poster; creating s.
   68         400.008, F.S.; providing legislative intent; requiring
   69         the Office of the State Long-Term Care Ombudsman to
   70         conduct unannounced quality-of-care evaluations of
   71         certain health and long-term care facilities;
   72         providing civil immunity from liability for certain
   73         personnel of the office who participate in
   74         evaluations; amending s. 400.0081, F.S.; requiring
   75         long-term care facilities to timely provide to the
   76         program, upon request, copies of records, policies, or
   77         documents needed to complete an investigation or
   78         assessment; requiring, rather than authorizing, the
   79         department to adopt rules to establish procedures to
   80         ensure access to facilities, residents, and records;
   81         amending s. 400.0083, F.S.; revising a penalty;
   82         requiring the Office of the State Long-Term Care
   83         Ombudsman to investigate alleged violations of willful
   84         interference with representatives of the State Long
   85         Term Care Ombudsman Program and retaliation against
   86         specified persons; requiring the office to report to
   87         the Agency for Health Care Administration if it is
   88         determined that a violation occurred; requiring the
   89         agency to impose a fine for certain instances of
   90         interference with or retaliation against the State
   91         Long-Term Care Ombudsman Program; requiring the agency
   92         to collect and transfer fines into the Quality of
   93         Long-Term Care Facility Improvement Trust Fund;
   94         requiring that the Division of Administrative Hearings
   95         conduct a hearing if a determination of a violation is
   96         contested; requiring the division to adopt rules;
   97         requiring the administrative law judge to render a
   98         decision within a specified timeframe after a hearing;
   99         requiring the Chief Inspector General to investigate
  100         any willful agency interference with the State Long
  101         Term Care Ombudsman Program; amending s. 400.0087,
  102         F.S.; requiring the nonprofit organization responsible
  103         for the day-to-day operations of the State Long-Term
  104         Care Ombudsman Program to consult with the state
  105         ombudsman in developing and submitting a budget to the
  106         department; limiting to a specified percentage the
  107         amount that the department may divert from the federal
  108         ombudsman appropriation to cover administrative costs
  109         associated with the State Long-Term Care Ombudsman
  110         Program; amending s. 400.0089, F.S.; specifying the
  111         information that must be included in quarterly reports
  112         required to be made by the State Long-Term Care
  113         Ombudsman Program; requiring the State Long-Term Care
  114         Ombudsman Program to include an analysis of such
  115         information in an annual report; amending s. 400.0091,
  116         F.S.; revising the subject areas that must be
  117         addressed in the curriculum for initial and continuing
  118         education training provided to representatives of the
  119         State Long-Term Care Ombudsman Program; creating s.
  120         400.0223, F.S.; defining the term “electronic
  121         monitoring device”; requiring nursing homes to allow
  122         residents, and certain individuals on their behalf, to
  123         monitor the residents’ rooms through the use of
  124         electronic monitoring devices; requiring nursing homes
  125         to require persons who conduct such monitoring to post
  126         a specific notice on the door to the residents’ rooms;
  127         providing that such monitoring is voluntary and may be
  128         conducted only at the request and expense of residents
  129         or certain individuals on their behalf; prohibiting
  130         nursing homes from making certain inquiries of
  131         prospective residents or of the representatives of
  132         prospective residents; prohibiting nursing homes from
  133         rejecting applications for residency or removing
  134         residents because of intent to use or use of
  135         electronic monitoring devices; requiring nursing homes
  136         to inform residents and specified individuals of the
  137         resident’s right to conduct electronic monitoring;
  138         requiring nursing homes to make reasonable physical
  139         accommodations for electronic monitoring and to
  140         provide a place for mounting and access to a power
  141         source; authorizing nursing homes to require that
  142         electronic monitoring be conducted in plain view;
  143         authorizing nursing homes to require that a request to
  144         conduct electronic monitoring be made in writing;
  145         providing that audio or video recordings created
  146         through the use of electronic monitoring may be
  147         admitted into evidence in court or administrative
  148         proceedings; providing criminal penalties for nursing
  149         home administrators who violate specified provisions
  150         relating to electronic monitoring; requiring prior
  151         written consent from a resident or certain individuals
  152         acting on the resident’s behalf before a nursing home
  153         employee, officer, or agent may interfere with an
  154         electronic monitoring device; providing a criminal
  155         penalty for such interference without prior written
  156         consent; imposing a civil penalty on nursing homes
  157         that violate provisions related to electronic
  158         monitoring; requiring the agency to transfer certain
  159         funds into the Quality of Long-Term Care Facility
  160         Improvement Trust Fund; repealing s. 400.0238, F.S.,
  161         relating to limitations on punitive damages; amending
  162         s. 400.0239, F.S.; conforming provisions to changes
  163         made by the act; creating s. 400.1185, F.S.; requiring
  164         licensed facilities to establish internal resident
  165         safety and quality-of-care coordinator programs;
  166         specifying required components for the programs,
  167         including development and implementation of a
  168         reporting system for adverse incidents; requiring that
  169         the reporting system require employees and agents to
  170         report adverse incidents to the facility’s quality-of
  171         care coordinator within a specified timeframe;
  172         assigning responsibility for the programs to facility
  173         governing boards; requiring facilities to hire a risk
  174         manager to serve as the quality-of-care coordinator;
  175         limiting the number of internal resident safety and
  176         quality-of-care programs that coordinators may be
  177         responsible for; encouraging the development of other
  178         approaches to reducing adverse incidents and
  179         violations of residents’ rights; requiring the agency
  180         to adopt rules to administer the programs; requiring
  181         that programs file all incident reports with a
  182         designated employee of the facility, who must meet
  183         certain requirements; providing immunity from civil
  184         liability for individuals who file incident reports;
  185         defining the term “adverse incident”; requiring
  186         facilities to submit annual reports that must include
  187         specified information to the agency by a specified
  188         date; requiring the agency to review the information
  189         submitted to determine whether disciplinary action is
  190         warranted; requiring facilities to submit an incident
  191         report and specified information to the agency within
  192         a certain timeframe after they receive the report;
  193         requiring the agency to determine within a certain
  194         timeframe whether certain adverse incidents have
  195         occurred; requiring the agency to require a written
  196         plan of correction from facilities that violate
  197         reporting requirements or provisions relating to the
  198         internal resident safety and quality-of-care
  199         coordinator programs; authorizing the agency to impose
  200         specified civil penalties and administrative fines for
  201         certain violations; requiring facilities to provide
  202         the agency with access to certain facility records;
  203         requiring the agency to review quality-of-care
  204         programs as part of its licensure inspection process;
  205         providing that, in the absence of intentional fraud,
  206         quality-of-care coordinators may not be held
  207         financially liable for actions taken within the scope
  208         of their authority in connection with the
  209         administration of this section; requiring the agency
  210         to report to the appropriate regulatory board its
  211         reasonable belief that the conduct of an agent or
  212         employee of a licensed facility constitutes grounds
  213         for disciplinary action; requiring the agency to
  214         publish on its website an annual report card
  215         containing specific information for licensed
  216         facilities beginning on a specified date; requiring
  217         the report card to include a specified statement;
  218         amending s. 400.141, F.S.; requiring a licensed
  219         nursing home to satisfy certain financial
  220         requirements; providing that the required funds may
  221         not be used for litigation costs or attorney fees in
  222         certain circumstances; creating s. 400.1411, F.S.;
  223         requiring nursing home facilities, as a condition of
  224         licensure, to demonstrate to the satisfaction of the
  225         agency and the Office of Insurance Regulation of the
  226         Financial Services Commission the financial ability to
  227         pay claims and costs arising out of the rendering of,
  228         or the failure to render, care or services; providing
  229         proper means of documentation; requiring insurers,
  230         self-insurers, and risk retention groups to promptly
  231         notify the agency and the office of cancellation or
  232         nonrenewal of insurance; requiring a licensee to pay
  233         the entire amount of a judgment, award, or settlement
  234         and all accrued interest if a court orders a final
  235         judgment against the licensee; providing that certain
  236         deceptive, untrue, or fraudulent representations or
  237         violations of financial requirements by any individual
  238         or entity on behalf of a facility may result in
  239         disciplinary action or a civil penalty with no
  240         aggregate limit; requiring the agency to issue a
  241         conditional license and authorizing the agency to
  242         immediately suspend a license if a facility shows a
  243         continuous pattern of violation of this section;
  244         amending s. 400.19, F.S.; requiring the agency to
  245         determine compliance with standards for electricity
  246         and emergency power sources during routine unannounced
  247         inspections of licensed nursing home facilities;
  248         amending s. 400.191, F.S.; requiring facilities that
  249         are on the Nursing Home Guide Watch List to
  250         conspicuously post a sign that meets certain
  251         requirements on each entrance to the facility for a
  252         certain period of time; requiring the agency to cite
  253         for a class I violation, place a facility on a 6-month
  254         inspection cycle, and extend the duration of a
  255         facility’s inclusion on the watch list for a specified
  256         additional period of time under certain circumstances;
  257         creating s. 400.226, F.S.; requiring licensed nursing
  258         homes to comply with certain federal rules and
  259         regulations; providing that a violation of such
  260         federal regulations is considered negligence per se;
  261         amending s. 400.23, F.S.; requiring the agency, in
  262         consultation with the Department of Health and the
  263         Department of Elderly Affairs, to adopt and enforce
  264         rules requiring a licensed nursing home facility to
  265         have adequate electrical equipment, an emergency power
  266         source, and a supply of fuel which meet specified
  267         criteria; requiring a comprehensive emergency plan to
  268         provide for the evacuation of all residents of a
  269         facility if the facility experiences a power outage
  270         and is unable to sustain adequate emergency power;
  271         requiring the agency to immediately impose a civil
  272         penalty in a specified amount on a facility if it
  273         determines that a resident of the facility died as the
  274         result of abuse or neglect; amending s. 406.11, F.S.;
  275         requiring medical examiners to determine the cause of
  276         death when a person dies in their district in a
  277         nursing home on the federal Special Focus Facility
  278         list or on the Nursing Home Guide Watch List; amending
  279         s. 406.13, F.S.; requiring a medical examiner to
  280         notify and forward documentation to the state attorney
  281         if he or she determines that a nursing home resident
  282         died as a result of abuse, sexual abuse, or
  283         negligence; requiring the state attorney to seat a
  284         grand jury within 90 days after receipt of such
  285         notification and investigate whether criminal charges
  286         are warranted; repealing s. 429.298, F.S., relating to
  287         limitations on punitive damages; amending s. 429.34,
  288         F.S.; requiring the agency to determine compliance
  289         with certain standards during the routine inspection
  290         of a licensed assisted living facility, including
  291         those related to construction and emergency power
  292         sources; amending s. 429.41, F.S.; requiring the
  293         Department of Elderly Affairs, in consultation with
  294         the agency, the Department of Children and Families,
  295         and the Department of Health, to adopt and enforce
  296         rules relating to electricity and requiring a licensed
  297         assisted living facility to maintain equipment
  298         sufficient to provide an emergency power source and a
  299         supply of fuel which meet specified criteria;
  300         requiring that a comprehensive emergency plan provide
  301         for the evacuation of all residents of a facility if
  302         the facility experiences a power outage and is unable
  303         to sustain emergency power as required; providing an
  304         effective date.
  305          
  306  Be It Enacted by the Legislature of the State of Florida:
  307  
  308         Section 1. Section 366.042, Florida Statutes, is created to
  309  read:
  310         366.042 Power restoration priority.—The commission shall
  311  ensure that public utilities have effectively prioritized, in
  312  the event of an emergency, the restoration of services to
  313  critical medical facilities, including nursing homes licensed
  314  under part II of chapter 400 and assisted living facilities
  315  licensed under part I of chapter 429.
  316         Section 2. Subsection (11) of section 366.15, Florida
  317  Statutes, is amended, and subsections (1) through (10) of that
  318  section are republished, to read:
  319         366.15 Medically essential electric public utility
  320  service.—
  321         (1) As used in this section, the term “medically essential”
  322  means the medical dependence on electric-powered equipment that
  323  must be operated continuously or as circumstances require as
  324  specified by a physician to avoid the loss of life or immediate
  325  hospitalization of the customer or another permanent resident at
  326  the residential service address.
  327         (2) Each public utility shall designate employees who are
  328  authorized to direct an ordered continuation or restoration of
  329  medically essential electric service. A public utility shall not
  330  impose upon any customer any additional deposit to continue or
  331  restore medically essential electric service.
  332         (3)(a) Each public utility shall annually provide a written
  333  explanation of the certification process for medically essential
  334  electric service to each utility customer. Certification of a
  335  customer’s electricity needs as medically essential requires the
  336  customer to complete forms supplied by the public utility and to
  337  submit a form completed by a physician licensed in this state
  338  pursuant to chapter 458 or chapter 459 which states in medical
  339  and nonmedical terms why the electric service is medically
  340  essential. False certification of medically essential service by
  341  a physician is a violation of s. 458.331(1)(h) or s.
  342  459.015(1)(i).
  343         (b) Medically essential service shall be recertified once
  344  every 12 months. The public utility shall send the certified
  345  customer by regular mail a package of recertification materials,
  346  including recertification forms, at least 30 days prior to the
  347  expiration of the customer’s certification. The materials shall
  348  advise the certified customer that he or she must complete and
  349  submit the recertification forms within 30 days after the
  350  expiration of customer’s existing certification. If the
  351  recertification forms are not received within this 30-day
  352  period, the public utility may terminate the customer’s
  353  certification.
  354         (4) Each public utility shall certify a customer’s electric
  355  service as medically essential if the customer completes the
  356  requirements of subsection (3).
  357         (5) Notwithstanding any other provision of this section, a
  358  public utility may disconnect service to a residence whenever an
  359  emergency may threaten the health or safety of a person, the
  360  surrounding area, or the public utility’s distribution system.
  361  The public utility shall act promptly to restore service as soon
  362  as feasible.
  363         (6) No later than 24 hours before any scheduled
  364  disconnection of service for nonpayment of bills to a customer
  365  who requires medically essential service, a public utility shall
  366  attempt to contact the customer by telephone in order to provide
  367  notice of the scheduled disconnection. If the customer does not
  368  have a telephone number listed on the account or if the public
  369  utility cannot reach the customer or other adult resident of the
  370  premises by telephone by the specified time, the public utility
  371  shall send a representative to the customer’s residence to
  372  attempt to contact the customer, no later than 4 p.m. of the day
  373  before scheduled disconnection. If contact is not made, however,
  374  the public utility may leave written notification at the
  375  residence advising the customer of the scheduled disconnection.
  376  Thereafter, the public utility may disconnect service on the
  377  specified date.
  378         (7) Each public utility customer who requires medically
  379  essential service is responsible for making satisfactory
  380  arrangements with the public utility to ensure payment for such
  381  service, and such arrangements must be consistent with the
  382  requirements of the utility’s tariff.
  383         (8) Each public utility customer who requires medically
  384  essential service is solely responsible for any backup equipment
  385  or power supply and a planned course of action in the event of a
  386  power outage or interruption of service.
  387         (9) Each public utility that provides electric service to
  388  any customer who requires medically essential service shall
  389  call, contact, or otherwise advise such customer of scheduled
  390  service interruptions.
  391         (10)(a) Each public utility shall provide information on
  392  sources of state or local agency funding which may provide
  393  financial assistance to the public utility’s customers who
  394  require medically essential service and who notify the public
  395  utility of their need for financial assistance.
  396         (b)1. Each public utility that operates a program to
  397  receive voluntary financial contributions from the public
  398  utility’s customers to provide assistance to persons who are
  399  unable to pay for the public utility’s services shall maintain a
  400  list of all agencies to which the public utility distributes
  401  such funds for such purposes and shall make the list available
  402  to any such person who requests the list.
  403         2. Each public utility that operates such a program shall:
  404         a. Maintain a system of accounting for the specific amounts
  405  distributed to each such agency, and the public utility and such
  406  agencies shall maintain a system of accounting for the specific
  407  amounts distributed to persons under such respective programs.
  408         b. Train its customer service representatives to assist any
  409  person who possesses a medically essential certification as
  410  provided in this section in identifying such agencies and
  411  programs.
  412         (11) Nothing in this act shall form the basis for any cause
  413  of action against a public utility. Failure to comply with any
  414  obligation created by this act does not constitute evidence of
  415  negligence on the part of the public utility.
  416         Section 3. Present subsections (3) through (14) of section
  417  400.0060, Florida Statutes, are redesignated as subsections (4)
  418  through (15), respectively, and a new subsection (3) is added to
  419  that section, to read:
  420         400.0060 Definitions.—When used in this part, unless the
  421  context clearly dictates otherwise, the term:
  422         (3) “Autonomy” means the freedom of residents from threats
  423  of interference, coercion, retaliation, or intimidation as they
  424  reside and receive care in a long-term care facility and as
  425  advocated for by the Office of the State Long-Term Care
  426  Ombudsman.
  427         Section 4. Section 400.0063, Florida Statutes, is amended
  428  to read:
  429         400.0063 Establishment of the State Long-Term Care
  430  Ombudsman Program; designation of ombudsman and legal advocate.—
  431         (1) The Office of There is created the State Long-Term Care
  432  Ombudsman is established within Program in the Department of
  433  Elderly Affairs to administer the State Long-Term Care Ombudsman
  434  Program. The office shall enter into a contract with, or make a
  435  grant to, a private nonprofit organization to oversee the day
  436  to-day operations of the program. The office does not have any
  437  responsibility with regard to the licensing or certification of
  438  long-term care facilities and may not have a relationship with
  439  any long-term care facility.
  440         (2)(a) The State Long-Term Care Ombudsman Program shall be
  441  headed by the State Long-Term Care Ombudsman, who shall serve on
  442  a full-time basis and shall personally, or through
  443  representatives of the program, carry out the its purposes and
  444  functions of the program in accordance with state and federal
  445  law.
  446         (b) A five-member selection panel appointed by the
  447  Secretary of Elderly Affairs shall appoint the state ombudsman,
  448  who must have shall be appointed by and shall serve at the
  449  pleasure of the Secretary of Elderly Affairs. The secretary
  450  shall appoint a person who has expertise in the operation of a
  451  nonprofit organization and at least 5 years of experience in the
  452  fields of long-term care resident and advocacy. The state
  453  ombudsman may be removed from office only by a two-thirds vote
  454  of the state council with the consent of the secretary and the
  455  private nonprofit organization that oversees the operations of
  456  the program. The to serve as state ombudsman shall register as a
  457  lobbyist pursuant to s. 11.045.
  458         (3)(a) The state ombudsman shall select a person who is a
  459  member in good standing of The Florida Bar to serve in the
  460  position of There is created in the office the position of legal
  461  advocate, which is created within the office. The legal
  462  advocate, who shall be selected by and serve at the pleasure of
  463  the state ombudsman, shall register as a lobbyist pursuant to s.
  464  11.045 and shall be a member in good standing of The Florida
  465  Bar.
  466         (b) The duties of the legal advocate shall include, but are
  467  not be limited to:
  468         1. Assisting the state ombudsman in carrying out the duties
  469  of the office with respect to the abuse, neglect, exploitation,
  470  or violation of rights of residents of long-term care
  471  facilities.
  472         2. Assisting the representatives of the State Long-Term
  473  Care Ombudsman Program in carrying out their responsibilities
  474  under this part.
  475         3. Pursuing administrative, legal, and other appropriate
  476  remedies on behalf of residents.
  477         4. Serving as legal counsel to the representatives of the
  478  State Long-Term Care Ombudsman Program in any suit or other
  479  legal action that is initiated in connection with the
  480  performance of the official duties of the representatives of the
  481  State Long-Term Care Ombudsman Program.
  482         5. Assisting the state ombudsman in ensuring that the
  483  program is operated autonomously; without conflict of interest;
  484  and without interference, coercion, or retaliation against those
  485  associated with the operation of the program.
  486         Section 5. Paragraph (f) of subsection (1) and paragraph
  487  (h) of subsection (2) of section 400.0065, Florida Statutes, are
  488  amended to read:
  489         400.0065 State Long-Term Care Ombudsman Program; duties and
  490  responsibilities.—
  491         (1) The purpose of the State Long-Term Care Ombudsman
  492  Program is to:
  493         (f) Support Administer the state and local councils.
  494         (2) The State Long-Term Care Ombudsman has the duty and
  495  authority to:
  496         (h) Prepare an annual report describing the activities
  497  carried out by the office, the state council, the districts, and
  498  the local councils in the year for which the report is prepared.
  499  The state ombudsman shall submit the report to the secretary,
  500  the United States Assistant Secretary for Aging, the Governor,
  501  the President of the Senate, the Speaker of the House of
  502  Representatives, the Secretary of Children and Families, and the
  503  Secretary of the Agency for Health Care Administration at least
  504  30 days before the convening of the regular session of the
  505  Legislature. The report must, at a minimum:
  506         1. Contain and analyze data collected concerning complaints
  507  about and conditions in long-term care facilities and the
  508  disposition of such complaints.
  509         2. Evaluate the problems experienced by residents.
  510         3. Analyze the successes of the State Long-Term Care
  511  Ombudsman Program during the preceding year, including an
  512  assessment of how successfully the program has carried out its
  513  responsibilities under the Older Americans Act and the laws of
  514  this state.
  515         4. Provide recommendations for policy, regulatory, and
  516  statutory changes designed to solve identified problems; resolve
  517  residents’ complaints; improve residents’ lives and quality of
  518  care; protect residents’ rights, health, safety, and welfare;
  519  and remove any barriers to the optimal operation of the State
  520  Long-Term Care Ombudsman Program.
  521         5. Contain recommendations from the State Long-Term Care
  522  Ombudsman Council, local councils, resident and family councils,
  523  and consumer advocacy groups regarding program functions and
  524  activities and recommendations for policy, regulatory, and
  525  statutory changes designed to protect residents’ rights, health,
  526  safety, and welfare.
  527         6. Contain any relevant recommendations from the
  528  representatives of the State Long-Term Care Ombudsman Program
  529  regarding program functions and activities.
  530         Section 6. Subsection (3) and paragraph (c) of subsection
  531  (4) of section 400.0067, Florida Statutes, are amended to read:
  532         400.0067 State Long-Term Care Ombudsman Council; duties;
  533  membership.—
  534         (3) The State Long-Term Care Ombudsman Council consists of
  535  one active certified ombudsman from each local council in each a
  536  district and one resident, one family member of a resident, and
  537  one consumer advocate, each appointed by the state ombudsman
  538  plus three at-large members.
  539         (a)Each local council in a district must select a
  540  representative of its choice to serve on the state council.
  541         (b)1. The state ombudsman shall submit to the secretary a
  542  list of individuals recommended for appointment to the at-large
  543  positions on the state council. The list may not include the
  544  name of any individual who is currently serving in a district.
  545         2. The secretary shall appoint three at-large members
  546  chosen from the list.
  547         (4)
  548         (c)1. The state council shall elect a chair to serve for a
  549  term of 1 year. A chair may not serve more than three two
  550  consecutive terms.
  551         2. The chair shall select a vice chair from among the
  552  members. The vice chair shall preside over the state council in
  553  the absence of the chair.
  554         3. The chair may create additional executive positions as
  555  necessary to carry out the duties of the state council. Any
  556  person appointed to an executive position shall serve at the
  557  pleasure of the chair, and his or her term shall expire on the
  558  same day as the term of the chair.
  559         4. A chair may be immediately removed from office before
  560  the expiration of his or her term by a vote of two-thirds of all
  561  state council members present at any meeting at which a quorum
  562  is present. If a chair is removed from office before the
  563  expiration of his or her term, a replacement chair shall be
  564  chosen during the same meeting in the same manner as described
  565  in this paragraph, and the term of the replacement chair shall
  566  begin immediately. The replacement chair shall serve for the
  567  remainder of the term and is eligible to serve three two
  568  subsequent consecutive terms.
  569         Section 7. Paragraphs (b) and (c) of subsection (1) and
  570  paragraph (d) of subsection (2) of section 400.0069, Florida
  571  Statutes, are amended to read:
  572         400.0069 Long-term care ombudsman districts; local long
  573  term care ombudsman councils; duties; appointment.—
  574         (1)
  575         (b) The state ombudsman shall ensure that there is at least
  576  one employee of the department certified as a long-term care
  577  ombudsman and a least one local council operating in each
  578  district. The state ombudsman may create additional local
  579  councils as necessary to ensure that residents throughout the
  580  state have meaningful adequate access to State Long-Term Care
  581  Ombudsman Program services.
  582         (c) Each district shall convene a public meeting at least
  583  monthly quarterly.
  584         (2) The duties of the representatives of the State Long
  585  Term Care Ombudsman Program are to:
  586         (d) Review and, upon an affirmative vote of the state
  587  council, if necessary, comment on all existing or proposed
  588  rules, regulations, and other governmental policies and actions
  589  relating to long-term care facilities which that may potentially
  590  have an effect on the health, safety, welfare, and rights of
  591  residents.
  592         Section 8. Section 400.0073, Florida Statutes, is amended
  593  to read:
  594         400.0073 State and local ombudsman council investigations.—
  595         (1) A representative of the State Long-Term Care Ombudsman
  596  Program shall identify and investigate, within a reasonable time
  597  after a complaint is made, by or on behalf of a resident
  598  relating to actions or omissions by providers or representatives
  599  of providers of long-term care services, other public agencies,
  600  guardians, or representative payees which may adversely affect
  601  the health, safety, welfare, or rights of residents.
  602         (2) Subsequent to an appeal from a local council, the state
  603  council may investigate any complaint received by the local
  604  council involving a long-term care facility or a resident.
  605         (3) The state council or a local council may hold a public
  606  hearing to assist the State Long-Term Care Ombudsman Program in
  607  its investigation of a complaint.
  608         (4)(3) If a representative of the State Long-Term Care
  609  Ombudsman Program is not allowed to enter a long-term care
  610  facility, the administrator of the facility shall be considered
  611  to have interfered with a representative of the State Long-Term
  612  Care Ombudsman Program in the performance of official duties as
  613  described in s. 400.0083(1) and to have violated this part. The
  614  representative of the State Long-Term Care Ombudsman Program
  615  shall report a facility’s refusal to allow entry to the state
  616  ombudsman or his or her designee, who shall report the incident
  617  to the agency, and the agency shall record the report and take
  618  it into consideration when determining actions allowable under
  619  s. 400.102, s. 400.121, s. 429.14, s. 429.19, s. 429.69, or s.
  620  429.71. The legal advocate shall pursue legal remedies against a
  621  person, a long-term care facility, or another entity that
  622  violates s. 400.0083(1).
  623         Section 9. Subsections (1), (4), and (5) of section
  624  400.0074, Florida Statutes, are amended to read:
  625         400.0074 Local ombudsman council onsite administrative
  626  assessments.—
  627         (1) A representative of the State Long-Term Care Ombudsman
  628  Program shall conduct, at least annually, an onsite
  629  administrative assessment of each nursing home, assisted living
  630  facility, and adult family-care home. This administrative
  631  assessment must be comprehensive in nature, must be resident
  632  centered, must include a review of the facility’s emergency
  633  management plan, and must focus on factors affecting residents’
  634  rights, health, safety, and welfare. Each local council is
  635  encouraged to conduct a similar onsite administrative assessment
  636  of each new additional long-term care facility within its
  637  jurisdiction.
  638         (4) An onsite administrative assessment may not be
  639  accomplished by forcible entry. However, if a representative of
  640  the State Long-Term Care Ombudsman Program is not allowed to
  641  enter a long-term care facility, the administrator of the
  642  facility shall be considered to have interfered with a
  643  representative of the State Long-Term Care Ombudsman Program in
  644  the performance of official duties as described in s.
  645  400.0083(1) and to have committed a violation of this part. The
  646  representative of the State Long-Term Care Ombudsman Program
  647  shall report the refusal by a facility to allow entry to the
  648  state ombudsman or his or her designee, who shall report the
  649  incident to the agency, and the agency shall record the report
  650  and take it into consideration when determining actions
  651  allowable under s. 400.102, s. 400.121, s. 429.14, s. 429.19, s.
  652  429.69, or s. 429.71. The legal advocate may pursue legal
  653  remedies for any violation of s. 400.0083.
  654         (5) The department, in consultation with the state
  655  ombudsman, shall may adopt rules implementing procedures for
  656  conducting onsite administrative assessments of long-term care
  657  facilities.
  658         Section 10. Subsection (3) of section 400.0077, Florida
  659  Statutes, is amended to read:
  660         400.0077 Confidentiality.—
  661         (3) All other matters before the council, including the
  662  public discussion of administrative assessments, shall be open
  663  to the public and subject to chapter 119 and s. 286.011.
  664         Section 11. Subsection (3) is added to section 400.0078,
  665  Florida Statutes, and subsections (1) and (2) of that section
  666  are republished, to read:
  667         400.0078 Citizen access to State Long-Term Care Ombudsman
  668  Program services.—
  669         (1) The office shall establish a statewide toll-free
  670  telephone number and e-mail address for receiving complaints
  671  concerning matters adversely affecting the health, safety,
  672  welfare, or rights of residents.
  673         (2) Upon admission to a long-term care facility, each
  674  resident or representative of a resident must receive
  675  information regarding:
  676         (a) The purpose of the State Long-Term Care Ombudsman
  677  Program.
  678         (b) The statewide toll-free telephone number and e-mail
  679  address for receiving complaints.
  680         (c) Information that retaliatory action cannot be taken
  681  against a resident for presenting grievances or for exercising
  682  any other resident right.
  683         (d) Other relevant information regarding how to contact
  684  representatives of the State Long-Term Care Ombudsman Program.
  685  
  686  Each resident or his or her representative must be furnished
  687  additional copies of this information upon request.
  688         (3) The State Long-Term Care Ombudsman Program shall create
  689  and make available a poster that includes the statewide toll
  690  free telephone number as described in subsection (1) and other
  691  relevant contact information for receiving complaints or a
  692  summary of residents’ rights. Each long-term care facility shall
  693  display a State Long-Term Care Ombudsman Program poster in
  694  multiple, conspicuous places.
  695         Section 12. Section 400.008, Florida Statutes, is created
  696  to read:
  697         400.008Unannounced quality-of-care evaluations.—
  698         (1) It is the intent of the Legislature that the
  699  environment in long-term care facilities be conducive to the
  700  dignity and autonomy of residents and that investigations by the
  701  Office of the State Long-Term Care Ombudsman safeguard the
  702  health, safety, and welfare of residents.
  703         (2) The Office of the State Long-Term Care Ombudsman shall
  704  conduct unannounced quality-of-care evaluations of health and
  705  long-term care facilities that provide services to the elderly.
  706  The office may use undercover personnel to act as patients or
  707  employees of the facility. The purpose of the evaluations is to:
  708         (a) Identify and track abuse and neglect issues and
  709  potential abuse and neglect issues in facilities;
  710         (b) Evaluate positive and negative aspects of facility care
  711  based on state rules and federal laws and regulations; and
  712         (c) Observe facilities’ actions to correct and resolve
  713  complaints or allegations of abuse, neglect, or exploitation.
  714         (3) Any employee or contractor of the Office of the State
  715  Long-Term Care Ombudsman who participates in an evaluation is
  716  immune from liability in any civil action related to the
  717  evaluation, provided that he or she acted in good faith during
  718  the course of the evaluation.
  719         Section 13. Section 400.0081, Florida Statutes, is amended
  720  to read:
  721         400.0081 Access to facilities, residents, and records.—
  722         (1) A long-term care facility shall provide representatives
  723  of the State Long-Term Care Ombudsman Program with access to:
  724         (a) The long-term care facility and its residents.
  725         (b) When Where appropriate, medical and social records of a
  726  resident for review if:
  727         1. The representative of the State Long-Term Care Ombudsman
  728  Program has the permission of the resident or the legal
  729  representative of the resident; or
  730         2. The resident is unable to consent to the review and does
  731  not have a legal representative.
  732         (c) Medical and social records of a resident as necessary
  733  to investigate a complaint, if:
  734         1. A legal representative or guardian of the resident
  735  refuses to give permission;
  736         2. The representative of the State Long-Term Care Ombudsman
  737  Program has reasonable cause to believe that the legal
  738  representative or guardian is not acting in the best interests
  739  of the resident; and
  740         3. The representative of the State Long-Term Care Ombudsman
  741  Program obtains the approval of the state ombudsman.
  742         (d) Administrative records, policies, and documents to
  743  which residents or the general public have access.
  744         (e) Upon request, copies of all licensing and certification
  745  records maintained by the state with respect to a long-term care
  746  facility.
  747         (2) Copies of records, policies, or documents needed to
  748  complete an investigation or assessment must be timely provided
  749  by the facility upon request and at no expense to the program.
  750         (3)(2) The department, in consultation with the state
  751  ombudsman, shall may adopt rules to establish procedures to
  752  ensure access to facilities, residents, and records as described
  753  in this section.
  754         Section 14. Section 400.0083, Florida Statutes, is amended
  755  to read:
  756         400.0083 Interference by a person, facility, or entity;
  757  retaliation prohibited; criminal penalties; administrative
  758  fines; interference by agency.—
  759         (1) A person, long-term care facility, or other entity may
  760  not willfully interfere with a representative of the State Long
  761  Term Care Ombudsman Program in the performance of his or her
  762  official duties.
  763         (2) A person, long-term care facility, or other entity may
  764  not knowingly or willfully take action or retaliate against any
  765  resident, employee, or other person for filing a complaint with,
  766  providing information to, or otherwise cooperating with any
  767  representative of the State Long-Term Care Ombudsman Program.
  768         (3) A person, long-term care facility, or other entity that
  769  violates this section:
  770         (a) Is liable for damages and equitable relief as
  771  determined by law.
  772         (b) Commits a misdemeanor of the first second degree,
  773  punishable as provided in s. 775.083.
  774         (4)The Office of the State Long-Term Care Ombudsman shall
  775  investigate each alleged violation of subsection (1) or
  776  subsection (2) to determine if a violation occurred. If the
  777  office determines that a violation occurred, it must report the
  778  determination to the agency. The agency shall impose a civil
  779  penalty of up to $5,000 per occurrence on a person, long-term
  780  care facility, or other entity that the office finds in
  781  violation of subsection (1) and a civil penalty of up to $10,000
  782  per occurrence on a person, long-term care facility, or other
  783  entity that the office finds in violation of subsection (2). The
  784  agency shall transfer funds collected pursuant to this
  785  subsection into the Quality of Long-Term Care Facility
  786  Improvement Trust Fund established under s. 400.0239. The
  787  Division of Administrative Hearings shall conduct a hearing if a
  788  determination of a violation is contested. The division shall
  789  establish by rule procedures for hearing requests. The
  790  administrative law judge must render a decision within 90 days
  791  after the hearing.
  792         (5) The Chief Inspector General shall investigate any
  793  willful agency interference with the activities of the State
  794  Long-Term Care Ombudsman Program in the performance of its
  795  official duties.
  796         Section 15. Subsections (1), (3), and (4) of section
  797  400.0087, Florida Statutes, are amended to read:
  798         400.0087 Department oversight; funding.—
  799         (1) The department shall perform its duties meet the costs
  800  associated with the State Long-Term Care Ombudsman Program from
  801  funds appropriated for that purpose to it.
  802         (a) The nonprofit organization responsible for the day-to
  803  day operations of the program, in consultation with the state
  804  ombudsman, shall develop and submit a budget to the department
  805  which must shall include the costs associated with
  806  administrative support of the State Long-Term Care Ombudsman
  807  Program when developing its budget requests for consideration by
  808  the Governor and submittal to the Legislature.
  809         (b) The department may divert from the federal ombudsman
  810  appropriation an amount equal to the department’s administrative
  811  cost ratio, which may not exceed 5 percent, to cover the costs
  812  associated with administering the State Long-Term Care Ombudsman
  813  Program. The remaining allotment from the Older Americans Act
  814  program shall be expended on direct ombudsman activities.
  815         (3) The department is responsible for ensuring that the
  816  State Long-Term Care Ombudsman Program:
  817         (a) Has the objectivity and autonomy independence required
  818  to qualify it for funding under the federal Older Americans Act.
  819         (b) Provides information to public and private agencies,
  820  legislators, and others.
  821         (c) Provides appropriate training to representatives of the
  822  State Long-Term Care Ombudsman Program.
  823         (d) Coordinates ombudsman services with Disability Rights
  824  Florida, the Advocacy Center for Persons with Disabilities and
  825  with providers of legal services to residents of long-term care
  826  facilities in compliance with state and federal laws.
  827         (4) The department shall also:
  828         (a) Receive and disburse state and federal funds for
  829  purposes that the state ombudsman has formulated in accordance
  830  with the Older Americans Act.
  831         (b) Whenever the state ombudsman deems necessary, act as
  832  liaison between agencies and branches of the federal and state
  833  governments and the State Long-Term Care Ombudsman Program.
  834         Section 16. Section 400.0089, Florida Statutes, is amended
  835  to read:
  836         400.0089 Complaint data reports.—
  837         (1) The State Long-Term Care Ombudsman Program shall
  838  maintain a statewide uniform reporting system to collect and
  839  analyze data relating to complaints and conditions in long-term
  840  care facilities and to residents for the purpose of identifying
  841  and resolving complaints.
  842         (2) Information pertaining to the number and types of
  843  complaints received by the State Long-Term Care Ombudsman
  844  Program shall be published quarterly and made readily available
  845  and shall include all of the following:
  846         (a) The license number, name, address, and county of each
  847  facility that is the subject of a complaint.
  848         (b) The case number and dates that each investigation was
  849  opened and closed.
  850         (c) The identified complaint codes for each case.
  851         (d) The National Ombudsman Reporting System description for
  852  each case.
  853         (e) The disposition of each case, specified by complaint
  854  code.
  855         (3) The State Long-Term Care Ombudsman Program shall
  856  include an analysis of such information in the annual report
  857  required under s. 400.0065.
  858         Section 17. Subsection (2) of section 400.0091, Florida
  859  Statutes, is amended to read:
  860         400.0091 Training.—The state ombudsman shall ensure that
  861  appropriate training is provided to all representatives of the
  862  State Long-Term Care Ombudsman Program.
  863         (2) The state ombudsman shall approve the curriculum for
  864  the initial and continuing education training, which must, at a
  865  minimum, address:
  866         (a) Resident confidentiality.
  867         (b) Guardianships and powers of attorney.
  868         (c) Medication administration.
  869         (d) Care and medication of residents with dementia and
  870  Alzheimer’s disease.
  871         (e) Accounting for residents’ funds.
  872         (f) Discharge rights and responsibilities.
  873         (g) Cultural sensitivity.
  874         (h) Person-centered care initiatives.
  875         (i) Abuse and neglect of residents.
  876         (j)(h) Any other topic related to residency in a long-term
  877  care facility.
  878         Section 18. Section 400.0223, Florida Statutes, is created
  879  to read:
  880         400.0223 Resident use of electronic monitoring devices in
  881  nursing homes.—
  882         (1) As used in this section, the term “electronic
  883  monitoring device” includes both of the following:
  884         (a) Video surveillance cameras installed in the room of a
  885  resident.
  886         (b) Audio devices installed in the room of a resident
  887  designed to acquire communications or other sounds occurring in
  888  the room.
  889         (2) A nursing home shall allow a resident; the resident’s
  890  surrogate; the resident’s guardian; or, at the resident’s
  891  request, the resident’s personal representative to monitor the
  892  resident’s room through the use of electronic monitoring
  893  devices.
  894         (3) The nursing home shall require the person who conducts
  895  electronic monitoring to post a notice on the door to the
  896  resident’s room stating that the room is being monitored by an
  897  electronic monitoring device.
  898         (4) Electronic monitoring conducted under this section is
  899  voluntary and may be conducted only at the request and expense
  900  of the resident, the resident’s surrogate, the resident’s
  901  guardian, or the resident’s personal representative. To the
  902  extent possible, such monitoring must protect the privacy rights
  903  of other residents and visitors to the nursing home.
  904         (5)(a) A nursing home may not inquire of a prospective
  905  resident or the representative of a prospective resident who is
  906  applying to reside at the facility regarding the resident’s
  907  intentions to use an electronic monitoring device and may not
  908  refuse an application for residency or remove a resident from
  909  the nursing home on the basis of intent to use or use of an
  910  electronic monitoring device.
  911         (b) A nursing home shall inform a resident, the resident’s
  912  surrogate, the resident’s guardian, or the personal
  913  representative of the resident of the resident’s right to
  914  conduct electronic monitoring.
  915         (6) A nursing home shall make reasonable physical
  916  accommodations to facilitate electronic monitoring and shall
  917  provide a reasonably secure place to mount an electronic
  918  monitoring device and access to a power source for the device.
  919         (7) If electronic monitoring is conducted by or on behalf
  920  of a resident, the nursing home may require the resident, the
  921  resident’s surrogate, the resident’s guardian, or the resident’s
  922  personal representative to conduct the electronic monitoring in
  923  plain view.
  924         (8) A nursing home may require that a request to conduct
  925  electronic monitoring be made in writing.
  926         (9) Subject to applicable rules of evidence and procedure,
  927  an audio or video recording created through the use of
  928  electronic monitoring conducted under this section may be
  929  admitted into evidence in any court or administrative
  930  proceeding.
  931         (10) An administrator of a nursing home who knowingly
  932  refuses to allow a resident; the resident’s surrogate; the
  933  resident’s guardian; or, at the request of the resident, the
  934  resident’s personal representative to monitor the room of the
  935  resident in accordance with this section through the use of an
  936  electronic monitoring device commits a misdemeanor of the second
  937  degree, punishable under s. 775.082 or s. 775.083.
  938         (11) An administrator of a nursing home who knowingly
  939  refuses to admit a person to residency or knowingly allows the
  940  removal of a resident from the nursing home because of a request
  941  to conduct electronic monitoring under this section commits a
  942  misdemeanor of the second degree, punishable under s. 775.082 or
  943  s. 775.083.
  944         (12)(a) An employee, officer, or other agent of a nursing
  945  home may not intentionally hamper, obstruct, tamper with, or
  946  destroy an electronic monitoring device installed in a
  947  resident’s room in accordance with this section, or a tape or
  948  recording made by such a device, unless he or she first obtains
  949  the written consent of the resident, the resident’s surrogate,
  950  the resident’s guardian, or the resident’s personal
  951  representative on a form provided by the agency. Such consent
  952  form must be signed by the resident or the person representing
  953  the resident who made the request and one other witness.
  954         (b) In the absence of such written consent, an employee,
  955  officer, or other agent of a nursing home who intentionally
  956  hampers, obstructs, tampers with, or destroys an electronic
  957  monitoring device installed in a resident’s room in accordance
  958  with this section, or a tape or recording made by such a device,
  959  commits a misdemeanor of the first degree, punishable under s.
  960  775.082 or s. 775.083.
  961         (13) The agency shall impose a civil penalty not to exceed
  962  $500 per violation per day on a licensee who operates a nursing
  963  home found to be in violation of this section. The agency shall
  964  transfer funds collected pursuant to this subsection into the
  965  Quality of Long-Term Care Facility Improvement Trust Fund
  966  established under s. 400.0239.
  967         Section 19. Section 400.0238, Florida Statutes, is
  968  repealed.
  969         Section 20. Subsection (1) of section 400.0239, Florida
  970  Statutes, is amended to read:
  971         400.0239 Quality of Long-Term Care Facility Improvement
  972  Trust Fund.—
  973         (1) There is created within the Agency for Health Care
  974  Administration a Quality of Long-Term Care Facility Improvement
  975  Trust Fund to support activities and programs directly related
  976  to improvement of the care of nursing home and assisted living
  977  facility residents. The trust fund shall be funded through
  978  proceeds generated pursuant to ss. 400.0083 and 400.0223 ss.
  979  400.0238 and 429.298, through funds specifically appropriated by
  980  the Legislature, through gifts, endowments, and other charitable
  981  contributions allowed under federal and state law, and through
  982  federal nursing home civil monetary penalties collected by the
  983  Centers for Medicare and Medicaid Services and returned to the
  984  state. These funds must be utilized in accordance with federal
  985  requirements.
  986         Section 21. Section 400.1185, Florida Statutes, is created
  987  to read:
  988         400.1185 Internal resident safety and quality-of-care
  989  coordinator program.—
  990         (1)Each licensed facility shall establish an internal
  991  resident safety and quality-of-care coordinator program that
  992  includes all of the following:
  993         (a)An analysis of the frequency and causes of violations
  994  of residents’ rights and of adverse incidents.
  995         (b)An analysis of resident and family member grievances
  996  that relate to resident safety and quality of care.
  997         (c)The development and implementation of measures to
  998  promote autonomy within the facility, to enhance the quality of
  999  life and the safety of residents, and to decrease the frequency
 1000  of violations of residents’ rights and of adverse incidents.
 1001         (d) Safety and risk prevention education and the training
 1002  of all nonphysician personnel who provide resident care, which
 1003  must be included as part of the initial orientation of such
 1004  personnel. Such personnel must complete at least 5 additional
 1005  hours of education and training annually.
 1006         (e)The development and implementation of a reporting
 1007  system that requires all employees and agents of the licensed
 1008  facility to report adverse incidents to the quality-of-care
 1009  coordinator, as described in subsection (2), or to his or her
 1010  designee, within 3 business days after the adverse incident
 1011  occurs.
 1012         (2)The internal resident safety and quality-of-care
 1013  coordinator programs are the responsibility of the governing
 1014  board of each facility. Each facility shall hire a risk manager
 1015  who shall act as the quality-of-care coordinator and be
 1016  responsible for implementation and oversight of the facility’s
 1017  internal resident safety and quality-of-care coordinator
 1018  program. The risk manager may not be made responsible for
 1019  internal resident safety and quality-of-care coordinator
 1020  programs in more than four facilities licensed under this
 1021  chapter.
 1022         (3)In addition to the programs created under this section,
 1023  the development of other innovative approaches is encouraged to
 1024  reduce the frequency and severity of adverse incidents and of
 1025  violations of residents’ rights.
 1026         (4)The agency shall adopt rules to administer the internal
 1027  resident safety and quality-of-care coordinator programs. Each
 1028  program must file any collected incident reports with an
 1029  employee designated by the facility, who must be proficient in
 1030  resident safety techniques and must have access to all resident
 1031  care and safety records of the facility, including internal and
 1032  state-required incident reports. An individual who files an
 1033  incident report is not subject to civil suit by virtue of filing
 1034  the incident report. For purposes of this section, the term
 1035  “adverse incident” means a situation that facility personnel
 1036  were in control of and that appropriate safety measures could
 1037  have prevented which results in any of the following to a
 1038  resident:
 1039         (a)Death.
 1040         (b)Brain or spinal damage.
 1041         (c)Permanent disfigurement.
 1042         (d)A fracture or dislocation of bones or joints.
 1043         (e)A limitation of neurological, physical, or sensory
 1044  function.
 1045         (f)Sexual abuse.
 1046         (g)Assault or battery.
 1047         (h)Any condition that requires the transfer of a resident
 1048  to a unit, within or outside of the facility, to provide a more
 1049  acute level of care.
 1050         (5)(a)By January 31 of each year, each licensed facility
 1051  shall submit a report to the agency summarizing incident reports
 1052  filed during the previous calendar year. The report must
 1053  include:
 1054         1. The total number of adverse incidents.
 1055         2.A listing, by category, of the causes of each injury or
 1056  death and the number of incidents occurring within each
 1057  category.
 1058         3.A code number using the facility staff’s licensure
 1059  number and a separate code number identifying all other
 1060  individuals directly involved in adverse incidents of residents,
 1061  the relationship of the individual to the licensed facility, and
 1062  the number of incidents in which each individual has been
 1063  directly involved. Each licensed facility shall maintain names
 1064  of the health care professionals and individuals identified by
 1065  code numbers for purposes of this section.
 1066         4.A description of all claims filed against the licensed
 1067  facility for a violation of a residents rights, as specified in
 1068  s. 400.022, including the total number of pending and closed
 1069  claims, the names of the individuals involved in each claim, the
 1070  nature of the incident that led to each claim, and the status
 1071  and disposition of each claim. Each report must provide an
 1072  updated status for any claims identified as being unresolved or
 1073  pending in the prior year report.
 1074         5.The number and nature of disciplinary actions taken
 1075  against agents or employees of the facility related to patient
 1076  care and safety.
 1077         (b)The agency shall review the information submitted
 1078  pursuant to paragraph (a) and determine if any reported
 1079  incidents may subject a facility or an employee or agent of a
 1080  facility to disciplinary action.
 1081         (c)The report submitted to the agency must also provide
 1082  the name and license number of the quality-of-care coordinator
 1083  of the licensed facility, a copy of the facility’s policies and
 1084  procedures that govern the actions taken by the facility and its
 1085  quality-of-care coordinator to reduce the risk of injuries and
 1086  deaths and violations of residents’ rights, and the results of
 1087  actions taken by the facility.
 1088         (6)(a)A licensed facility shall submit an adverse incident
 1089  report to the agency no later than 1 business day after the
 1090  quality-of-care coordinator or his or her designee has received
 1091  the report through the system implemented pursuant to paragraph
 1092  (1)(e). The report may be submitted to the agency through e
 1093  mail, facsimile, or overnight mail delivery. The facility must
 1094  submit the following information with the report:
 1095         1.The identity of the affected resident;
 1096         2.The type of adverse incident;
 1097         3.Information on any investigation into the incident
 1098  conducted by the facility; and
 1099         4.An assessment as to whether the events causing or
 1100  resulting in the adverse incident represent a potential risk to
 1101  other residents.
 1102         (b) After receiving the report, the agency must determine
 1103  by the end of the next business day if any of the following
 1104  adverse incidents has occurred, whether arising from events that
 1105  occurred in the licensed facility or from events that occurred
 1106  before the resident’s admission into the licensed facility:
 1107         1. The death of a resident;
 1108         2. Brain or spinal damage to a resident;
 1109         3. Sexual abuse of a resident; or
 1110         4. The assault or battery of a resident.
 1111         (7)The agency shall require a written plan of correction
 1112  from a facility that violates this section. For a single
 1113  incident or a series of isolated incidents that are nonwillful
 1114  violations of the reporting requirements of this section, the
 1115  agency shall first demand that the facility take corrective
 1116  action. If the facility does not demonstrate completion of the
 1117  corrective action within the timeframe allowed by the agency or
 1118  demonstrates a pattern of nonwillful violations of this section,
 1119  the agency may impose a civil penalty not to exceed $5,000 for
 1120  each violation of the reporting requirements of this section.
 1121  The civil penalty for repeated nonwillful violations may not
 1122  exceed $10,000 for each violation. The administrative fine for
 1123  each intentional and willful violation may not exceed $25,000
 1124  per violation per day.
 1125         (8) The agency must be given access to facility records
 1126  needed in the administration of this section.
 1127         (9)The agency shall review, as part of its licensure
 1128  inspection process, the internal resident safety and quality-of
 1129  care coordinator program at each licensed facility subject to
 1130  this section to determine whether it complies with this section,
 1131  is being conducted in a manner designed to reduce adverse
 1132  incidents and violations of residents’ rights, and is
 1133  appropriately reporting incidents under subsections (4) through
 1134  (6).
 1135         (10)There shall be no monetary liability on the part of,
 1136  and no cause of action for damages shall arise against, any
 1137  quality-of-care coordinator for the implementation and oversight
 1138  of an internal resident safety and quality-of-care coordinator
 1139  program for any act or proceeding undertaken or performed within
 1140  the scope of the functions of the program so long as the
 1141  quality-of-care coordinator acts without intentional fraud.
 1142         (11)If the agency, through its receipt of the annual
 1143  reports required in subsection (5) or through any investigation,
 1144  has a reasonable belief that the conduct of an agent or employee
 1145  of a licensed facility constitutes grounds for disciplinary
 1146  action by the appropriate regulatory board, the agency must
 1147  report its findings to that board.
 1148         (12)Beginning on July 1, 2019, and by each July 1
 1149  thereafter, the agency shall publish on its website a report
 1150  card summarizing the information contained in the annual reports
 1151  submitted by licensed facilities pursuant to subsection (5) and
 1152  disciplinary actions reported to the agency. The report card
 1153  must be organized by county and, for each licensed facility in
 1154  the state, must include an itemized list that provides the
 1155  following information:
 1156         (a)The name and address of the facility.
 1157         (b)If the facility is structured as a private for-profit,
 1158  not-for-profit, or public company.
 1159         (c)The total number of beds in the facility.
 1160         (d)A description of the categories of services provided by
 1161  the facility.
 1162         (e)The percentage of adverse incidents per total number of
 1163  residents in the facility, by category of reported incident.
 1164         (f)The number of claims filed for violations of the
 1165  resident’s rights under s. 400.022, by category of violation.
 1166         (g)A listing, by category, of the actions or inactions
 1167  giving rise to the adverse incidents and claims filed for a
 1168  violation of a resident’s rights and the number in each
 1169  category.
 1170         (h)The number of and descriptions of disciplinary actions
 1171  taken against a facility or agents or employees of that
 1172  facility.
 1173         (i) The following statement:
 1174  
 1175         “This report card is just one measure of the quality
 1176         of a facility. You may want to obtain and consider
 1177         other information to determine whether this facility
 1178         is right for you or your loved ones. This report card
 1179         is not adjusted to reflect the size of the facility or
 1180         the severity or complexity of the custodial and health
 1181         care needs of the residents it serves, and, therefore,
 1182         some facilities may appear to have more frequent
 1183         adverse incidents and claims involving violations of
 1184         residents’ rights than others.”
 1185  
 1186  The first report card issued pursuant to this subsection may be
 1187  based on a partial year of data, if necessary.
 1188         Section 22. Paragraph (q) of subsection (1) of section
 1189  400.141, Florida Statutes, is amended to read:
 1190         400.141 Administration and management of nursing home
 1191  facilities.—
 1192         (1) Every licensed facility shall comply with all
 1193  applicable standards and rules of the agency and shall:
 1194         (q) Satisfy the financial requirements in s. 400.1411,
 1195  which may not be used for litigation costs or attorney fees for
 1196  the defense of any claim against a nursing home facility
 1197  pursuant to common law or s. 400.023 or s. 400.0233 Maintain
 1198  general and professional liability insurance coverage that is in
 1199  force at all times. In lieu of satisfying the financial
 1200  requirements in s. 400.1411 such coverage, a state-designated
 1201  teaching nursing home and its affiliated assisted living
 1202  facilities created under s. 430.80 may demonstrate proof of
 1203  financial responsibility as provided in s. 430.80(3)(g).
 1204         Section 23. Section 400.1411, Florida Statutes, is created
 1205  to read:
 1206         400.1411Financial requirements.—
 1207         (1) As a condition of licensure, a nursing home facility
 1208  must at all times demonstrate to the satisfaction of the agency
 1209  and the Office of Insurance Regulation of the Financial Services
 1210  Commission the financial ability to pay claims, and costs
 1211  ancillary thereto, arising out of the rendering of, or the
 1212  failure to render, care or services, by doing one of the
 1213  following:
 1214         (a) Establishing and maintaining an escrow account
 1215  consisting of cash or assets eligible for deposit in accordance
 1216  with s. 625.52 in the per-claim amounts specified in paragraph
 1217  (b).
 1218         (b) Obtaining and maintaining general and professional
 1219  liability coverage in an amount not less than $1 million per
 1220  claim, with a minimum annual aggregate of not less than $3
 1221  million, from an authorized insurer as defined in s. 624.09,
 1222  from an eligible surplus lines insurer as defined in s.
 1223  626.914(2), or from a Florida-domiciled risk retention group as
 1224  defined in s. 627.942(9).
 1225         (c) Obtaining and maintaining an unexpired, irrevocable
 1226  letter of credit, established pursuant to chapter 675, in an
 1227  amount not less than $1 million per claim, with a minimum
 1228  aggregate availability of credit not less than $3 million. The
 1229  letter of credit must be payable to the nursing home facility as
 1230  beneficiary upon presentment of a final judgment indicating
 1231  liability and awarding damages to be paid by the nursing home
 1232  facility or upon presentment of a settlement agreement signed by
 1233  all parties to such agreement when such final judgment or
 1234  settlement is a result of a claim arising out of the rendering
 1235  of, or the failure to render, care and services. The letter of
 1236  credit must be nonassignable and nontransferable. The letter of
 1237  credit must be issued by a bank or savings association organized
 1238  and existing under the laws of this state or under the laws of
 1239  the United States which has its principal place of business in
 1240  this state or has a branch office authorized under the laws of
 1241  this state or of the United States to receive deposits in this
 1242  state.
 1243         (2) Each insurer, self-insurer, or risk retention group
 1244  must promptly notify the agency and the office of cancellation
 1245  or nonrenewal of insurance required by this section.
 1246         (3) Upon the entry by a Florida court of an adverse final
 1247  judgment against a licensee as defined in s. 400.023(2) which
 1248  arises from an award pursuant to s. 400.023, including an
 1249  arbitration award, for a claim of negligence or a violation of
 1250  residents’ rights, in contract or tort, or from noncompliance
 1251  with the terms of a settlement agreement as determined by a
 1252  court or arbitration panel which arises from a claim pursuant to
 1253  s. 400.023, the licensee shall pay the plaintiff the entire
 1254  amount of the judgment, award, or settlement and all accrued
 1255  interest pursuant to s. 400.024.
 1256         (4) Any deceptive, untrue, or fraudulent representation or
 1257  violation of this section by any individual or entity on behalf
 1258  of the facility may result in disciplinary action pursuant to s.
 1259  400.121 with no aggregate limit. If a nursing home shows a
 1260  continuous pattern of violation of this section, the agency must
 1261  issue a conditional license and may immediately suspend the
 1262  license.
 1263         Section 24. Subsection (3) of section 400.19, Florida
 1264  Statutes, is amended to read:
 1265         400.19 Right of entry and inspection.—
 1266         (3) Every 15 months, the agency shall every 15 months
 1267  conduct at least one unannounced inspection to determine
 1268  compliance by the licensee with the laws of this state and
 1269  administrative rules that govern statutes, and with rules
 1270  promulgated under the provisions of those statutes, governing
 1271  minimum standards of construction, electricity, and emergency
 1272  power sources; quality and adequacy of care;, and rights of
 1273  residents. The survey shall be conducted every 6 months for the
 1274  next 2-year period If a the facility has been cited for a class
 1275  I deficiency or, has been cited for two or more class II
 1276  deficiencies arising from separate surveys or investigations
 1277  within a 60-day period, or has had three or more substantiated
 1278  complaints within a 6-month period, each resulting in at least
 1279  one class I or class II deficiency, the agency shall conduct
 1280  unannounced inspections at 6-month intervals over the course of
 1281  the next 2-year period. In addition to any other fees or fines
 1282  in this part, the agency shall assess a fine for each facility
 1283  that is subject to the 6-month survey cycle. The fine for the 2
 1284  year period is shall be $6,000, one-half to be paid at the
 1285  completion of each survey. The agency may adjust this fine by
 1286  the change in the Consumer Price Index, based on the 12 months
 1287  immediately preceding the increase, to cover the cost of the
 1288  additional surveys. The agency shall verify through subsequent
 1289  inspection that any deficiency identified during inspection is
 1290  corrected. However, the agency may verify the correction of a
 1291  class III or class IV deficiency unrelated to resident rights or
 1292  resident care without reinspecting the facility if adequate
 1293  written documentation has been received from the facility, which
 1294  provides assurance that the deficiency has been corrected. The
 1295  giving or causing to be given of advance notice of such
 1296  unannounced inspections by an employee of the agency to any
 1297  unauthorized person constitutes grounds shall constitute cause
 1298  for the suspension of such person, pursuant to chapter 110, for
 1299  not fewer than 5 working days according to the provisions of
 1300  chapter 110.
 1301         Section 25. Subsection (3) of section 400.191, Florida
 1302  Statutes, is amended to read:
 1303         400.191 Availability, distribution, and posting of reports
 1304  and records.—
 1305         (3) Each nursing home facility licensee shall maintain as
 1306  public information, available upon request, records of all cost
 1307  and inspection reports pertaining to that facility which that
 1308  have been filed with, or issued by, any governmental agency.
 1309  Copies of the reports shall be retained in the records for not
 1310  less than 5 years following the date the reports are filed or
 1311  issued.
 1312         (a) The agency shall publish in the Nursing Home Guide a
 1313  “Nursing Home Guide Watch List” to assist consumers in
 1314  evaluating the quality of nursing home care in Florida. The
 1315  watch list must identify each facility that met the criteria for
 1316  a conditional licensure status and each facility that is
 1317  operating under bankruptcy protection. The watch list must
 1318  include, but need is not be limited to, the facility’s name,
 1319  address, and ownership; the county in which the facility
 1320  operates; the license expiration date; the number of licensed
 1321  beds; a description of the deficiency causing the facility to be
 1322  placed on the list; any corrective action taken; and the
 1323  cumulative number of days and percentage of days the facility
 1324  had a conditional license in the past 30 months. The watch list
 1325  must include a brief description regarding how to choose a
 1326  nursing home, the categories of licensure, the agency’s
 1327  inspection process, an explanation of terms used in the watch
 1328  list, and the addresses and phone numbers of the agency’s health
 1329  quality assurance field offices.
 1330         (b) Upon publication of each Nursing Home Guide, the agency
 1331  shall must post a copy of the guide on its website by the 15th
 1332  calendar day of the second month following the end of the
 1333  calendar quarter. Each nursing home licensee must retrieve the
 1334  most recent version of the Nursing Home Guide from the agency’s
 1335  website.
 1336         (c)1. A facility on the watch list must conspicuously post
 1337  a sign on each entrance to the facility. The lettering must be
 1338  red, in at least 48-point type, and printed on white card stock.
 1339  The sign must read as follows:
 1340  
 1341   “NOTICE: THIS FACILITY IS ON FLORIDA’S NURSING HOME GUIDE WATCH 
 1342                               LIST.”                              
 1343  
 1344         2. Signs must remain posted for the duration of the 30
 1345  month watch list period. If the agency determines that a
 1346  facility is in violation of this section, the agency must cite
 1347  the facility for a class I violation, place the facility on a 6
 1348  month inspection cycle, and extend the duration of the
 1349  facility’s inclusion on the watch list for an additional 30
 1350  months.
 1351         Section 26. Section 400.226, Florida Statutes, is created
 1352  to read:
 1353         400.226 Mandatory compliance with federal requirements.
 1354  Licensed nursing homes shall comply with the requirements of 42
 1355  C.F.R. 483, which are incorporated herein by reference. A
 1356  violation of the residents’ rights established under this
 1357  section is considered negligence per se.
 1358         Section 27. Paragraphs (d) and (g) of subsection (2) and
 1359  paragraph (a) of subsection (8) of section 400.23, Florida
 1360  Statutes, are amended to read:
 1361         400.23 Rules; evaluation and deficiencies; licensure
 1362  status.—
 1363         (2) Pursuant to the intention of the Legislature, the
 1364  agency, in consultation with the Department of Health and the
 1365  Department of Elderly Affairs, shall adopt and enforce rules to
 1366  implement this part and part II of chapter 408, which shall
 1367  include reasonable and fair criteria in relation to:
 1368         (d) The equipment essential to the health and welfare of
 1369  the residents, including equipment sufficient to provide
 1370  adequate day-to-day electricity, a fully operational emergency
 1371  power source, and a supply of fuel sufficient to sustain the
 1372  emergency power source for at least 96 hours during a power
 1373  outage. The emergency power source must provide enough
 1374  electricity to consistently maintain an air temperature between
 1375  71° and 81° F in the facility.
 1376         (g) The preparation and annual update of a comprehensive
 1377  emergency management plan. The agency shall adopt rules
 1378  establishing minimum criteria for the plan after consultation
 1379  with the Division of Emergency Management. At a minimum, the
 1380  rules must provide for plan components that address emergency
 1381  evacuation transportation; adequate sheltering arrangements;
 1382  postdisaster activities, including emergency power, food, and
 1383  water; postdisaster transportation; supplies; staffing;
 1384  emergency equipment; individual identification of residents and
 1385  transfer of records; and responding to family inquiries. The
 1386  plan must provide for the evacuation of all residents in the
 1387  event that the facility experiences a power outage and is unable
 1388  to sustain adequate emergency power as required in paragraph
 1389  (d). The comprehensive emergency management plan is subject to
 1390  review and approval by the local emergency management agency.
 1391  During its review, the local emergency management agency shall
 1392  ensure that the following agencies, at a minimum, are given the
 1393  opportunity to review the plan: the Department of Elderly
 1394  Affairs, the Department of Health, the Agency for Health Care
 1395  Administration, and the Division of Emergency Management. Also,
 1396  appropriate volunteer organizations must be given the
 1397  opportunity to review the plan. The local emergency management
 1398  agency shall complete its review within 60 days and either
 1399  approve the plan or advise the facility of necessary revisions.
 1400         (8) The agency shall adopt rules pursuant to this part and
 1401  part II of chapter 408 to provide that, when the criteria
 1402  established under subsection (2) are not met, such deficiencies
 1403  shall be classified according to the nature and the scope of the
 1404  deficiency. The scope shall be cited as isolated, patterned, or
 1405  widespread. An isolated deficiency is a deficiency affecting one
 1406  or a very limited number of residents, or involving one or a
 1407  very limited number of staff, or a situation that occurred only
 1408  occasionally or in a very limited number of locations. A
 1409  patterned deficiency is a deficiency where more than a very
 1410  limited number of residents are affected, or more than a very
 1411  limited number of staff are involved, or the situation has
 1412  occurred in several locations, or the same resident or residents
 1413  have been affected by repeated occurrences of the same deficient
 1414  practice but the effect of the deficient practice is not found
 1415  to be pervasive throughout the facility. A widespread deficiency
 1416  is a deficiency in which the problems causing the deficiency are
 1417  pervasive in the facility or represent systemic failure that has
 1418  affected or has the potential to affect a large portion of the
 1419  facility’s residents. The agency shall indicate the
 1420  classification on the face of the notice of deficiencies as
 1421  follows:
 1422         (a) A class I deficiency is a deficiency that the agency
 1423  determines presents a situation in which immediate corrective
 1424  action is necessary because the facility’s noncompliance has
 1425  caused, or is likely to cause, serious injury, harm, impairment,
 1426  or death to a resident receiving care in a facility. The
 1427  condition or practice constituting a class I violation shall be
 1428  abated or eliminated immediately, unless a fixed period of time,
 1429  as determined by the agency, is required for correction. A class
 1430  I deficiency is subject to a civil penalty of $10,000 for an
 1431  isolated deficiency, $12,500 for a patterned deficiency, and
 1432  $15,000 for a widespread deficiency. If the agency determines
 1433  that a resident died as the result of abuse or neglect, it shall
 1434  immediately impose a $1 million civil penalty on the facility
 1435  for the deficiency. The fine amount shall be doubled for each
 1436  deficiency if the facility was previously cited for one or more
 1437  class I or class II deficiencies during the last licensure
 1438  inspection or any inspection or complaint investigation since
 1439  the last licensure inspection. A fine must be levied
 1440  notwithstanding the correction of the deficiency.
 1441         Section 28. Paragraph (a) of subsection (1) of section
 1442  406.11, Florida Statutes, is amended to read:
 1443         406.11 Examinations, investigations, and autopsies.—
 1444         (1) In any of the following circumstances involving the
 1445  death of a human being, the medical examiner of the district in
 1446  which the death occurred or the body was found shall determine
 1447  the cause of death and shall, for that purpose, make or have
 1448  performed such examinations, investigations, and autopsies as he
 1449  or she shall deem necessary or as shall be requested by the
 1450  state attorney:
 1451         (a) When any person dies in the state:
 1452         1. Of criminal violence.
 1453         2. By accident.
 1454         3. By suicide.
 1455         4. Suddenly, when in apparent good health.
 1456         5. Unattended by a practicing physician or other recognized
 1457  practitioner.
 1458         6. In any prison or penal institution.
 1459         7. In any nursing home on the federal Special Focus
 1460  Facility list or on the Nursing Home Guide Watch List as
 1461  described in s. 400.191(3)(a).
 1462         8.7. In police custody.
 1463         9.8. In any suspicious or unusual circumstance.
 1464         10.9. By criminal abortion.
 1465         11.10. By poison.
 1466         12.11. By disease constituting a threat to public health.
 1467         13.12. By disease, injury, or toxic agent resulting from
 1468  employment.
 1469         Section 29. Section 406.13, Florida Statutes, is amended to
 1470  read:
 1471         406.13 Examiner’s report; maintenance of records.—Upon
 1472  receipt of such notification pursuant to s. 406.12, the district
 1473  medical examiner or her or his associate shall examine or
 1474  otherwise take charge of the dead body and shall notify the
 1475  appropriate law enforcement agency pursuant to s. 406.145. When
 1476  the cause of death has been established within reasonable
 1477  medical certainty by the district medical examiner or her or his
 1478  associate, she or he shall so report or make available to the
 1479  state attorney, in writing, her or his determination as to the
 1480  cause of said death. If it is determined that a nursing home
 1481  resident died as the result of abuse, sexual abuse, or
 1482  negligence, the medical examiner must notify and forward all
 1483  documentation in support of the determination to the state
 1484  attorney. Upon receipt of such notification, the state attorney
 1485  shall seat a grand jury within 90 days and investigate whether
 1486  the filing of criminal charges is warranted. Duplicate copies of
 1487  records and the detailed findings of autopsy and laboratory
 1488  investigations shall be maintained by the district medical
 1489  examiner. Any evidence or specimen coming into the possession of
 1490  said medical examiner in connection with any investigation or
 1491  autopsy may be retained by the medical examiner or be delivered
 1492  to one of the law enforcement officers assigned to the
 1493  investigation of the death.
 1494         Section 30. Section 429.298, Florida Statutes, is repealed.
 1495         Section 31. Subsection (2) of section 429.34, Florida
 1496  Statutes, is amended to read:
 1497         429.34 Right of entry and inspection.—
 1498         (2) The agency shall inspect each licensed assisted living
 1499  facility at least once every 24 months to determine compliance
 1500  by the licensee with this chapter and related rules governing
 1501  minimum standards of construction, electricity, and emergency
 1502  power sources; quality and adequacy of care; and resident
 1503  rights. If an assisted living facility is cited for a class I
 1504  violation or three or more class II violations arising from
 1505  separate surveys within a 60-day period or due to unrelated
 1506  circumstances during the same survey, the agency must conduct an
 1507  additional licensure inspection within 6 months.
 1508         Section 32. Paragraphs (a) and (b) of subsection (1) of
 1509  section 429.41, Florida Statutes, are amended to read:
 1510         429.41 Rules establishing standards.—
 1511         (1) It is the intent of the Legislature that rules
 1512  published and enforced pursuant to this section shall include
 1513  criteria by which a reasonable and consistent quality of
 1514  resident care and quality of life may be ensured and the results
 1515  of such resident care may be demonstrated. Such rules shall also
 1516  ensure a safe and sanitary environment that is residential and
 1517  noninstitutional in design or nature. It is further intended
 1518  that reasonable efforts be made to accommodate the needs and
 1519  preferences of residents to enhance the quality of life in a
 1520  facility. Uniform firesafety standards for assisted living
 1521  facilities shall be established by the State Fire Marshal
 1522  pursuant to s. 633.206. The agency, in consultation with the
 1523  department, may adopt rules to administer the requirements of
 1524  part II of chapter 408. In order to provide safe and sanitary
 1525  facilities and the highest quality of resident care
 1526  accommodating the needs and preferences of residents, the
 1527  department, in consultation with the agency, the Department of
 1528  Children and Families, and the Department of Health, shall adopt
 1529  rules, policies, and procedures to administer this part, which
 1530  must include reasonable and fair minimum standards in relation
 1531  to:
 1532         (a) The requirements for and maintenance of facilities, not
 1533  in conflict with chapter 553, relating to electricity, plumbing,
 1534  heating, cooling, lighting, ventilation, living space, and other
 1535  housing conditions, which will ensure the health, safety, and
 1536  comfort of residents suitable to the size of the structure.
 1537         1. Firesafety evacuation capability determination.—An
 1538  evacuation capability evaluation for initial licensure shall be
 1539  conducted within 6 months after the date of licensure.
 1540         2. Firesafety requirements.—
 1541         a. The National Fire Protection Association, Life Safety
 1542  Code, NFPA 101 and 101A, current editions, shall be used in
 1543  determining the uniform firesafety code adopted by the State
 1544  Fire Marshal for assisted living facilities, pursuant to s.
 1545  633.206.
 1546         b. A local government or a utility may charge fees only in
 1547  an amount not to exceed the actual expenses incurred by the
 1548  local government or the utility relating to the installation and
 1549  maintenance of an automatic fire sprinkler system in a licensed
 1550  assisted living facility structure.
 1551         c. All licensed facilities must have an annual fire
 1552  inspection conducted by the local fire marshal or authority
 1553  having jurisdiction.
 1554         d. An assisted living facility that is issued a building
 1555  permit or certificate of occupancy before July 1, 2016, may at
 1556  its option and after notifying the authority having
 1557  jurisdiction, remain under the provisions of the 1994 and 1995
 1558  editions of the National Fire Protection Association, Life
 1559  Safety Code, NFPA 101, and NFPA 101A. The facility opting to
 1560  remain under such provisions may make repairs, modernizations,
 1561  renovations, or additions to, or rehabilitate, the facility in
 1562  compliance with NFPA 101, 1994 edition, and may utilize the
 1563  alternative approaches to life safety in compliance with NFPA
 1564  101A, 1995 edition. However, a facility for which a building
 1565  permit or certificate of occupancy is issued before July 1,
 1566  2016, that undergoes Level III building alteration or
 1567  rehabilitation, as defined in the Florida Building Code, or
 1568  seeks to utilize features not authorized under the 1994 or 1995
 1569  editions of the Life Safety Code must thereafter comply with all
 1570  aspects of the uniform firesafety standards established under s.
 1571  633.206, and the Florida Fire Prevention Code, in effect for
 1572  assisted living facilities as adopted by the State Fire Marshal.
 1573         3. Resident elopement requirements.—Facilities are required
 1574  to conduct a minimum of two resident elopement prevention and
 1575  response drills per year. All administrators and direct care
 1576  staff must participate in the drills which shall include a
 1577  review of procedures to address resident elopement. Facilities
 1578  must document the implementation of the drills and ensure that
 1579  the drills are conducted in a manner consistent with the
 1580  facility’s resident elopement policies and procedures.
 1581         4. Emergency power sources for use during power outages.
 1582  Facilities are required to maintain a fully operational
 1583  emergency power source and a supply of fuel sufficient to
 1584  sustain the emergency power source for at least 96 hours during
 1585  a power outage. The emergency power source must provide enough
 1586  electricity to consistently maintain an air temperature between
 1587  71° and 81° F in the facility.
 1588         (b) The preparation and annual update of a comprehensive
 1589  emergency management plan. Such standards must be included in
 1590  the rules adopted by the department after consultation with the
 1591  Division of Emergency Management. At a minimum, the rules must
 1592  provide for plan components that address emergency evacuation
 1593  transportation; adequate sheltering arrangements; postdisaster
 1594  activities, including provision of emergency power, food, and
 1595  water; postdisaster transportation; supplies; staffing;
 1596  emergency equipment; individual identification of residents and
 1597  transfer of records; communication with families; and responses
 1598  to family inquiries. The comprehensive emergency management plan
 1599  must provide for the evacuation of all residents of a facility
 1600  if the facility experiences a power outage and is unable to
 1601  sustain emergency power, as required in subparagraph (a)4. The
 1602  comprehensive emergency management plan is subject to review and
 1603  approval by the local emergency management agency. During its
 1604  review, the local emergency management agency shall ensure that
 1605  the following agencies, at a minimum, are given the opportunity
 1606  to review the plan: the Department of Elderly Affairs, the
 1607  Department of Health, the Agency for Health Care Administration,
 1608  and the Division of Emergency Management. Also, appropriate
 1609  volunteer organizations must be given the opportunity to review
 1610  the plan. The local emergency management agency shall complete
 1611  its review within 60 days and either approve the plan or advise
 1612  the facility of necessary revisions.
 1613         Section 33. This act shall take effect July 1, 2018.

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