Bill Text: FL S1102 | 2010 | Regular Session | Introduced

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Bill Title: Assisted Living Facilities/Residents [SPSC]

Spectrum: Partisan Bill (Republican 2-0)

Status: (Failed) 2010-04-30 - Died in Committee on Children, Families, and Elder Affairs, companion bill(s) passed, see CS/CS/SB 1412 (Ch. 2010-102) [S1102 Detail]

Download: Florida-2010-S1102-Introduced.html

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Florida Senate - 2010                                    SB 1102 
 
By Senator Fasano 
11-00635D-10                                          20101102__ 
1                        A bill to be entitled 
2         An act relating to residents of assisted living 
3         facilities; amending s. 429.07, F.S.; conforming 
4         provisions to changes made by the act; amending s. 
5         429.28, F.S.; revising provisions relating to a 
6         resident’s right to receive notice before being 
7         relocated or terminated from a facility; providing 
8         that a document that waives such right is void; 
9         requiring a facility’s grievance procedure to be in 
10         writing; creating s. 429.285, F.S.; providing the 
11         grounds and notice requirements for relocating or 
12         terminating a resident from a facility; authorizing 
13         the Department of Elderly Affairs to adopt rules; 
14         amending s. 429.31, F.S.; conforming provisions to 
15         changes made by the act; providing an effective date. 
16 
17  Be It Enacted by the Legislature of the State of Florida: 
18 
19         Section 1. Paragraphs (b) and (c) of subsection (3) of 
20  section 429.07, Florida Statutes, are amended to read: 
21         429.07 License required; fee.— 
22         (3) In addition to the requirements of s. 408.806, each 
23  license granted by the agency must state the type of care for 
24  which the license is granted. Licenses shall be issued for one 
25  or more of the following categories of care: standard, extended 
26  congregate care, limited nursing services, or limited mental 
27  health. 
28         (b) An extended congregate care license shall be issued to 
29  facilities providing, directly or through contract, services 
30  beyond those authorized in paragraph (a), including services 
31  performed by persons licensed under acts performed pursuant to 
32  part I of chapter 464 by persons licensed thereunder, and 
33  supportive services, as defined by rule, to persons who would 
34  otherwise would be disqualified from continued residence in a 
35  facility licensed under this part. 
36         1. In order for extended congregate care services to be 
37  provided in a facility licensed under this part, the agency must 
38  first determine that all requirements established in law and 
39  rule are met and must specifically designate, on the facility’s 
40  license, that such services may be provided and whether the 
41  designation applies to all or part of a facility. Such 
42  designation may be made at the time of initial licensure or 
43  relicensure, or upon request in writing by a licensee under this 
44  part and part II of chapter 408. Notification of approval or 
45  denial of the such request shall be made in accordance with part 
46  II of chapter 408. Existing facilities qualifying to provide 
47  extended congregate care services must have maintained a 
48  standard license and may not have been subject to administrative 
49  sanctions during the previous 2 years, or since initial 
50  licensure if the facility has been licensed for less than 2 
51  years, for any of the following reasons: 
52         a. A class I or class II violation; 
53         b. Three or more repeat or recurring class III violations 
54  of identical or similar resident care standards as specified in 
55  rule from which a pattern of noncompliance is found by the 
56  agency; 
57         c. Three or more class III violations that were not 
58  corrected in accordance with the corrective action plan approved 
59  by the agency; 
60         d. Violation of resident care standards resulting in a 
61  requirement to employ the services of a consultant pharmacist or 
62  consultant dietitian; 
63         e. Denial, suspension, or revocation of a license for 
64  another facility under this part in which the applicant for an 
65  extended congregate care license has at least 25 percent 
66  ownership interest; or 
67         f. Imposition of a moratorium pursuant to this part or part 
68  II of chapter 408 or initiation of injunctive proceedings. 
69         2. Facilities that are licensed to provide extended 
70  congregate care services shall maintain a written progress 
71  report on each person who receives such services, which report 
72  describes the type, amount, duration, scope, and outcome of 
73  services that are rendered and the general status of the 
74  resident’s health. A registered nurse, or appropriate designee, 
75  representing the agency shall visit such facilities at least 
76  quarterly to monitor residents who are receiving extended 
77  congregate care services and to determine if the facility is in 
78  compliance with this part, part II of chapter 408, and rules 
79  that relate to extended congregate care. One of these visits may 
80  be in conjunction with the regular survey. The monitoring visits 
81  may be provided through contractual arrangements with 
82  appropriate community agencies. A registered nurse shall serve 
83  as part of the team that inspects the such facility. The agency 
84  may waive one of the required yearly monitoring visits for a 
85  facility that has been licensed for at least 24 months to 
86  provide extended congregate care services, if, during the 
87  inspection, the registered nurse determines that extended 
88  congregate care services are being provided appropriately, and 
89  if the facility has no class I or class II violations and no 
90  uncorrected class III violations. Before such decision is made, 
91  the agency shall consult with the long-term care ombudsman 
92  council for the area in which the facility is located to 
93  determine if any complaints have been made and substantiated 
94  about the quality of services or care. The agency may not waive 
95  one of the required yearly monitoring visits if complaints have 
96  been made and substantiated. 
97         3. Facilities that are licensed to provide extended 
98  congregate care services shall: 
99         a. Demonstrate the capability to meet unanticipated 
100  resident service needs. 
101         b. Offer a physical environment that promotes a homelike 
102  setting, provides for resident privacy, promotes resident 
103  independence, and allows sufficient congregate space as defined 
104  by rule. 
105         c. Have sufficient staff available, taking into account the 
106  physical plant and firesafety features of the building, to 
107  assist with the evacuation of residents in an emergency, as 
108  necessary. 
109         d. Adopt and follow policies and procedures that maximize 
110  resident independence, dignity, choice, and decisionmaking to 
111  permit residents to age in place to the extent possible, so that 
112  moves due to changes in functional status are minimized or 
113  avoided. 
114         e. Allow residents or, if applicable, a resident’s 
115  representative, designee, surrogate, guardian, or attorney in 
116  fact to make a variety of personal choices, participate in 
117  developing service plans, and share responsibility in 
118  decisionmaking. 
119         f. Implement the concept of managed risk. 
120         g. Provide, either directly or through contract, the 
121  services of a person licensed pursuant to part I of chapter 464. 
122         h. In addition to the training mandated in s. 429.52, 
123  provide specialized training as defined by rule for facility 
124  staff. 
125         4. Facilities licensed to provide extended congregate care 
126  services are exempt from the criteria for continued residency as 
127  set forth in rules adopted under s. 429.41. Facilities so 
128  licensed shall adopt their own requirements within guidelines 
129  for continued residency set forth by rule. However, such 
130  facilities may not serve residents who require 24-hour nursing 
131  supervision. Facilities licensed to provide extended congregate 
132  care services shall provide each resident with a written copy of 
133  facility policies governing admission and retention. 
134         5. The primary purpose of extended congregate care services 
135  is to allow residents, as they become more impaired, the option 
136  of remaining in a familiar setting from which they would 
137  otherwise be disqualified for continued residency. A facility 
138  licensed to provide extended congregate care services may also 
139  admit an individual who exceeds the admission criteria for a 
140  facility with a standard license, if the individual is 
141  determined appropriate for admission to the extended congregate 
142  care facility. 
143         6. Before admission of an individual to a facility licensed 
144  to provide extended congregate care services, the individual 
145  must undergo a medical examination as provided in s. 429.26(4) 
146  and the facility must develop a preliminary service plan for the 
147  individual. 
148         7. If When a facility can no longer provide or arrange for 
149  services in accordance with the resident’s service plan and 
150  needs and the facility’s policy, the facility shall make 
151  arrangements for relocating the person in accordance with s. 
152  429.285 s. 429.28(1)(k). 
153         8. Failure to provide extended congregate care services may 
154  result in denial of extended congregate care license renewal. 
155         9. By No later than January 1 of each year, the department, 
156  in consultation with the agency, shall prepare and submit to the 
157  Governor, the President of the Senate, the Speaker of the House 
158  of Representatives, and the chairs of appropriate legislative 
159  committees, a report on the status of, and recommendations 
160  related to, extended congregate care services. The status report 
161  must include, but need not be limited to, the following 
162  information: 
163         a. A description of the facilities licensed to provide such 
164  services, including total number of beds licensed under this 
165  part. 
166         b. The number and characteristics of residents receiving 
167  such services. 
168         c. The types of services rendered that could not be 
169  provided through a standard license. 
170         d. An analysis of deficiencies cited during licensure 
171  inspections. 
172         e. The number of residents who required extended congregate 
173  care services at admission and the source of admission. 
174         f. Recommendations for statutory or regulatory changes. 
175         g. The availability of extended congregate care to state 
176  clients residing in facilities licensed under this part and in 
177  need of additional services, and recommendations for 
178  appropriations to subsidize extended congregate care services 
179  for such persons. 
180         h. Such other information as the department considers 
181  appropriate. 
182         (c) A limited nursing services license shall be issued to a 
183  facility that provides services beyond those authorized in 
184  paragraph (a) and as specified in this paragraph. 
185         1. In order for limited nursing services to be provided in 
186  a facility licensed under this part, the agency must first 
187  determine that all requirements established in law and rule are 
188  met and must specifically designate, on the facility’s license, 
189  that such services may be provided. Such designation may be made 
190  at the time of initial licensure or relicensure, or upon request 
191  in writing by a licensee under this part and part II of chapter 
192  408. Notification of approval or denial of such request shall be 
193  made in accordance with part II of chapter 408. Existing 
194  facilities qualifying to provide limited nursing services shall 
195  have maintained a standard license and may not have been subject 
196  to administrative sanctions that affect the health, safety, and 
197  welfare of residents for the previous 2 years or since initial 
198  licensure if the facility has been licensed for less than 2 
199  years. 
200         2. Facilities that are licensed to provide limited nursing 
201  services shall maintain a written progress report on each person 
202  who receives such nursing services, which report describes the 
203  type, amount, duration, scope, and outcome of services that are 
204  rendered and the general status of the resident’s health. A 
205  registered nurse representing the agency shall visit such 
206  facilities at least twice a year to monitor residents who are 
207  receiving limited nursing services and to determine if the 
208  facility is in compliance with applicable provisions of this 
209  part, part II of chapter 408, and related rules. The monitoring 
210  visits may be provided through contractual arrangements with 
211  appropriate community agencies. A registered nurse shall also 
212  serve as part of the team that inspects the such facility. 
213         3. A person who receives limited nursing services under 
214  this part must meet the admission criteria established by the 
215  agency for assisted living facilities. If When a resident no 
216  longer meets the admission criteria for a facility licensed 
217  under this part, arrangements for relocating the person shall be 
218  made in accordance with s. 429.285 s. 429.28(1)(k), unless the 
219  facility is also licensed to provide extended congregate care 
220  services. 
221         Section 2. Paragraphs (k) and (l) of subsection (1) of 
222  section 429.28, Florida Statutes, are amended to read: 
223         429.28 Resident bill of rights.— 
224         (1) No resident of a facility shall be deprived of any 
225  civil or legal rights, benefits, or privileges guaranteed by 
226  law, the Constitution of the State of Florida, or the 
227  Constitution of the United States as a resident of a facility. 
228  Every resident of a facility shall have the right to: 
229         (k) Receive notice, as provided in s. 429.285, before at 
230  least 45 days’ notice of relocation or termination of residency 
231  from the facility unless, for medical reasons, the resident is 
232  certified by a physician to require an emergency relocation to a 
233  facility providing a more skilled level of care or the resident 
234  engages in a pattern of conduct that is harmful or offensive to 
235  other residents. Such notice is not required if the relocation 
236  or termination of residency is initiated by the resident or the 
237  resident’s designee. Admission to a facility may not be 
238  conditioned upon a waiver of this right, and any provision in a 
239  document which purports to waive or preclude such right is void 
240  and unenforceable. In the case of a resident who has been 
241  adjudicated mentally incapacitated, the guardian shall be given 
242  at least 45 days’ notice of a nonemergency relocation or 
243  residency termination. Reasons for relocation shall be set forth 
244  in writing. In order for a facility to terminate the residency 
245  of an individual without notice as provided herein, the facility 
246  shall show good cause in a court of competent jurisdiction. 
247         (l) Present grievances and recommend changes in policies, 
248  procedures, and services to the staff of the facility, governing 
249  officials, or any other person without restraint, interference, 
250  coercion, discrimination, or reprisal. Each facility shall 
251  establish a written grievance procedure to facilitate the 
252  residents’ exercise of this right. This right includes access to 
253  ombudsman volunteers and advocates and the right to be a member 
254  of, to be active in, and to associate with advocacy or special 
255  interest groups. 
256         Section 3. Section 429.285, Florida Statutes, is created to 
257  read: 
258         429.285 Relocation or termination of residency.— 
259         (1) A resident may not be relocated or terminated from a 
260  facility unless: 
261         (a) The resident’s needs cannot be met in the facility and 
262  the relocation or termination is necessary for the resident’s 
263  welfare; 
264         (b) The resident no longer needs the services provided by 
265  the facility; 
266         (c) The health and safety of other residents or facility 
267  staff are endangered; 
268         (d) There is a documented pattern of harmful or offensive 
269  behavior by the resident; 
270         (e) The resident has failed, after at least 30 days’ 
271  notice, to provide payment for his or her stay in the facility; 
272  or 
273         (f) The facility ceases to operate. 
274         (2) The department shall develop a standard form to be used 
275  by a facility to provide written notice to a resident of a 
276  proposed relocation or termination of residency. At a minimum, 
277  the notice must specify: 
278         (a) The grounds authorized under subsection (1) for 
279  relocation or termination of residency and the specific facts 
280  relating to the resident which support those grounds. 
281         (b) The effective date of the proposed relocation or 
282  termination and the name and address of the location to which 
283  the resident would be relocated. 
284         (c) The right and procedure for requesting the local long 
285  term care ombudsman council to review the proposed relocation or 
286  termination. 
287         (d) All information required by state laws and rules. 
288         (e) Any other pertinent information. 
289         (3) At least 45 days before the relocation or termination 
290  of the resident, the facility must provide by certified mail 
291  written notice of the proposed relocation or termination to the 
292  resident’s legal guardian or representative, if known. If the 
293  resident has been adjudicated mentally incapacitated, the notice 
294  must be provided to the resident’s legal guardian. 
295         (4) If the relocation or termination of a resident is 
296  initiated by the facility, the administrator or designee must 
297  sign the written notice of relocation or termination. A copy of 
298  the notice must also be signed by the resident and placed in the 
299  resident’s file. If the relocation or termination is for medical 
300  reasons, the notice must be signed by the resident’s physician, 
301  or the physician’s written order for relocation or termination 
302  must be attached to the notice. 
303         (5) A copy of a notice of relocation or termination of 
304  residency initiated by a facility must be submitted to the 
305  Office of State Long-Term Care Ombudsman by mail, electronic 
306  mail, or facsimile within 2 business days after a resident’s 
307  receipt of the notice to relocate or terminate residency. A 
308  resident may request a review of the proposed relocation or 
309  termination by the local long-term care ombudsman council. 
310         (6) In the event of an emergency relocation or termination 
311  of residency for medical reasons, as certified by a physician, 
312  or due to harmful or offensive conduct by the resident, notice 
313  must be provided to the resident’s legal guardian or 
314  representative, if known, and the Office of the State Long-Term 
315  Ombudsman, by telephone or in person as soon as practicable, but 
316  within 2 business days after the emergency relocation or 
317  termination. The resident’s file must include documentation 
318  indicating who was contacted, whether the contact was by 
319  telephone or in person, and the date and time of the contact. 
320  The written notice described in subsection (2) shall be given 
321  before the relocation or termination of residency if possible, 
322  but within 5 business days after the emergency relocation or 
323  termination. 
324         (7) A facility that terminates the residency of an 
325  individual without providing written notice as required under 
326  this section must be able to show good cause in a court of 
327  competent jurisdiction. 
328         (8) The department may adopt rules to administer this 
329  section. 
330         Section 4. Subsection (1) of section 429.31, Florida 
331  Statutes, is amended to read: 
332         429.31 Closing of facility; notice; penalty.— 
333         (1) In addition to the requirements of part II of chapter 
334  408, the facility shall inform each resident or the next of kin, 
335  legal representative, or agency acting on the each resident’s 
336  behalf, of the fact and the proposed time of discontinuance of 
337  operation in accordance with s. 429.285, following the 
338  notification requirements provided in s. 429.28(1)(k). If In the 
339  event a resident does not have anyone has no person to represent 
340  him or her, the facility shall refer the resident be responsible 
341  for referral to an appropriate social service agency for 
342  placement. 
343         Section 5. This act shall take effect July 1, 2010.