Bill Text: FL S2074 | 2012 | Regular Session | Comm Sub
Bill Title: Assisted Living Facilities
Spectrum: Committee Bill
Status: (Introduced - Dead) 2012-03-09 - Laid on Table -SJ 1218 [S2074 Detail]
Download: Florida-2012-S2074-Comm_Sub.html
Florida Senate - 2012 CS for SB 2074 By the Committees on Health Regulation; and Health Regulation 588-02729B-12 20122074c1 1 A bill to be entitled 2 An act relating to assisted living facilities; 3 amending s. 394.4574, F.S.; revising the duties of the 4 case manager for, and the community living support 5 plan of, a mental health resident of an assisted 6 living facility; amending s. 400.0078, F.S.; requiring 7 that residents of long-term care facilities be 8 informed about the confidentiality of the subject 9 matter and identity of the complainant of a complaint 10 received by the State Long-Term Care Ombudsman 11 Program; amending s. 415.1034, F.S.; adding certain 12 employees or agents of a state or local agency to the 13 list of persons who must report the known or suspected 14 abuse of a vulnerable adult to the abuse hotline; 15 amending s. 429.02, F.S.; providing definitions for 16 “board” and “mental health professional”; amending s. 17 429.07, F.S.; conforming a cross-reference; increasing 18 the biennial license fee required for a facility that 19 has certain violations within the 2 years preceding 20 license renewal; amending s. 429.075, F.S.; revising 21 the criteria preventing a licensed facility from 22 receiving a limited mental health license; providing 23 training requirements for administrators and staff 24 members of facilities that hold a limited mental 25 health license; requiring that a mental health 26 professional be part of the team inspecting a facility 27 that holds a limited mental health license; requiring 28 quarterly monitoring of the facility; providing for an 29 exception from quarterly monitoring; amending s. 30 429.14, F.S.; requiring the revocation of a facility 31 license for certain violations that result in the 32 death of a resident; amending s. 429.176, F.S.; 33 requiring the licensure of facility administrators; 34 providing administrator education and examination 35 requirements; providing training requirements for 36 facility managers during the temporary absence of an 37 administrator; amending s. 429.178, F.S.; revising 38 training requirements for staff who provide care for 39 persons with Alzheimer’s disease and related 40 disorders; amending s. 429.19, F.S.; conforming 41 provisions to changes made by the act; authorizing the 42 Agency for Health Care Administration to impose an 43 increased fine for certain violations that result in 44 the death of a resident; amending s. 429.23, F.S.; 45 requiring a facility to establish a risk management 46 and quality assurance program; amending s. 429.256, 47 F.S.; conforming a cross-reference; amending s. 48 429.28, F.S.; requiring residents of facilities to be 49 informed about the confidentiality of the subject 50 matter and identity of the resident and complainant of 51 a complaint made to the State Long-Term Care Ombudsman 52 Program; requiring the agency to conduct followup 53 inspections of facilities that have a history of 54 certain violations; providing that a facility that 55 terminates an individual’s residency will be fined if 56 good cause is not shown in court; amending s. 429.34, 57 F.S.; providing that the agency is designated as the 58 central agency for receiving and tracking facility 59 complaints; requiring the agency to have lead 60 surveyors who specialize in assessing facilities; 61 amending s. 429.41, F.S.; requiring the agency to 62 observe the elopement drills of a randomly selected 63 group of facilities; authorizing the agency to require 64 additional staffing for facilities that hold a 65 specialty license; requiring the agency to conduct an 66 abbreviated biennial licensure inspection; amending s. 67 429.49, F.S.; increasing the criminal penalty for 68 altering facility records; creating s. 429.515, F.S.; 69 requiring new facility employees to attend a 70 preservice orientation; providing requirements for 71 such orientation; amending s. 429.52, F.S.; revising 72 training and continuing education requirements for 73 facility staff other than administrators; providing 74 for the use of interactive online tutorials; creating 75 s. 429.521, F.S.; providing specialty training 76 requirements for certain staff of facilities that hold 77 an extended congregate care, limited nursing, and 78 limited mental health license; providing for 79 examinations; authorizing the Board of Assisted Living 80 Facility Administration to adopt rules; creating s. 81 429.522, F.S.; requiring training providers to be 82 certified by the board and provide trainer oversight; 83 providing trainer requirements; requiring the board to 84 maintain an electronic database of certified providers 85 and persons who complete training if funding is 86 available; creating s. 429.523, F.S.; providing for 87 board approval of training and testing centers; 88 providing approval criteria; amending s. 429.54, F.S.; 89 requiring specified state agencies to have an 90 electronic system of communication pertaining to the 91 regulation of facilities; requiring facilities to 92 submit certain facility and resident information 93 electronically to the agency twice yearly; providing 94 for the maintenance and use of such information; 95 providing for expiration of this requirement; creating 96 s. 429.55, F.S.; directing the agency to establish an 97 online, user-friendly facility rating system that may 98 be accessed by the public; providing a directive to 99 the Division of Statutory Revision; amending s. 100 468.1635, F.S.; revising the purpose of part II of ch. 101 468, F.S., to include assisted living administrators; 102 amending s. 468.1645, F.S.; requiring assisted living 103 facilities to be operated under the management of a 104 licensed administrator; amending s. 468.1655, F.S.; 105 revising and providing definitions; amending s. 106 468.1665, F.S.; renaming the Board of Nursing Home 107 Administrators as the “Board of Nursing Home and 108 Assisted Living Facility Administrators”; providing 109 for membership; prohibiting certain conflicts of 110 interest with respect to board members; amending s. 111 468.1685, F.S.; revising duties of the board to 112 include approving third-party credentialing entities 113 for the purpose of an assisted living facility 114 administrator certification program; establishing 115 requirements and standards for certification; 116 providing for the development of assisted living 117 facility administrator trainings and testing and staff 118 trainings and interactive tutorials; authorizing 119 additional training for certain facilities; providing 120 for certifying trainers and testing and training 121 centers; amending s. 468.1695, F.S.; providing for 122 licensure of assisted living facility administrators 123 through certification; establishing a maximum fee; 124 amending s. 468.1705, F.S., relating to licensure by 125 endorsement; conforming provisions to changes made by 126 the act; amending s. 468.1725, F.S.; revising 127 provisions relating to the inactive status of an 128 administrator’s license; amending s. 468.1735, F.S., 129 relating to provisional licensing; conforming 130 provisions to changes made by the act; amending s. 131 468.1745, F.S.; providing requirements for who must be 132 licensed as an assisted living facility administrator; 133 amending s. 468.1755, F.S.; conforming provisions to 134 changes made by the act; providing grounds for 135 disciplinary action for assisted living facility 136 administrators; amending s. 468.1756, F.S.; conforming 137 provisions to changes made by the act; requiring the 138 agency to create a task force to determine whether 139 state agencies have overlapping regulatory 140 jurisdiction over facilities and to submit findings 141 and recommendations to the Governor and Legislature by 142 a certain date; providing for termination; requiring 143 the Office of the State Long-Term Care Ombudsman to 144 create a task force to review the agency’s facility 145 inspection forms and to submit its recommendations to 146 the agency by a certain date; providing for 147 termination; providing an effective date. 148 149 Be It Enacted by the Legislature of the State of Florida: 150 151 Section 1. Paragraph (e) of subsection (2) of section 152 394.4574, Florida Statutes, is amended, and paragraph (f) is 153 added to that subsection, to read: 154 394.4574 Department responsibilities for a mental health 155 resident who resides in an assisted living facility that holds a 156 limited mental health license.— 157 (2) The department must ensure that: 158 (e) The mental health services provider assigns a case 159 manager to each mental health resident who lives in an assisted 160 living facility with a limited mental health license. The case 161 manager is responsible for coordinating the developmentofand 162 implementation of the community living support plan defined in 163 s. 429.02. The plan must be updated as needed, but at least 164 annually, to ensure that the ongoing needs of the resident are 165 addressed. Each case manager shall keep a record of the date and 166 time of any face-to-face interaction with the mental health 167 resident and make the record available to the department for 168 inspection. The record must be retained for 2 years after the 169 date of the last interaction. 170 (f) There is adequate and consistent monitoring and 171 enforcement of community living support plans and cooperative 172 agreements by the department. 173 Section 2. Subsection (2) of section 400.0078, Florida 174 Statutes, is amended to read: 175 400.0078 Citizen access to State Long-Term Care Ombudsman 176 Program services.— 177 (2)Every resident or representative of a resident shall178receive,Upon admission to a long-term care facility, each 179 resident or representative of a resident must receive 180 information regarding the purpose of the State Long-Term Care 181 Ombudsman Program, the statewide toll-free telephone number for 182 receiving complaints, the confidentiality of the subject matter 183 of a complaint and the complainant’s name and identity, and 184 other relevant information regarding how to contact the program. 185 Residents or their representatives must be furnished additional 186 copies of this information upon request. 187 Section 3. Paragraph (a) of subsection (1) of section 188 415.1034, Florida Statutes, is amended to read: 189 415.1034 Mandatory reporting of abuse, neglect, or 190 exploitation of vulnerable adults; mandatory reports of death.— 191 (1) MANDATORY REPORTING.— 192 (a) Any person, including, but not limited to, any: 193 1. A physician, osteopathic physician, medical examiner, 194 chiropractic physician, nurse, paramedic, emergency medical 195 technician, or hospital personnel engaged in the admission, 196 examination, care, or treatment of vulnerable adults; 197 2. A health professional or mental health professional 198 other than one listed in subparagraph 1.; 199 3. A practitioner who relies solely on spiritual means for 200 healing; 201 4. Nursing home staff; assisted living facility staff; 202 adult day care center staff; adult family-care home staff; 203 social worker; or other professional adult care, residential, or 204 institutional staff; 205 5. A state, county, or municipal criminal justice employee 206 or law enforcement officer; 207 6. An employee of the Department of Business and 208 Professional Regulation conducting inspections of public lodging 209 establishments under s. 509.032; 210 7. A Florida advocacy council member or long-term care 211 ombudsman council member;or212 8. A bank, savings and loan, or credit union officer, 213 trustee, or employee; or 214 9. An employee or agent of a state or local agency who has 215 regulatory responsibilities over, or who provides services to, 216 persons residing in a state-licensed facility, 217 218 who knows, or has reasonable cause to suspect, that a vulnerable 219 adult has been or is being abused, neglected, or exploited must 220shallimmediately report such knowledge or suspicion to the 221 central abuse hotline. 222 Section 4. Subsections (5) and (11) of section 429.02, 223 Florida Statutes, are amended, present subsections (6) through 224 (14) of that section are redesignated as subsections (7) through 225 (15), respectively, present subsections (15) through (26) of 226 that section are redesignated as subsections (17) through (28), 227 respectively, and new subsections (6) and (16) are added to that 228 section, to read: 229 429.02 Definitions.—When used in this part, the term: 230 (5) “Assisted living facility” or “facility” means any 231 building or buildings, section or distinct part of a building, 232 private home, boarding home, home for the aged, or other 233 residential facility, whether operated for profit or not, which 234 undertakes through its ownership or management to provide 235 housing, meals, and one or more personal services for a period 236 exceeding 24 hours to one or more adults who are not relatives 237 of the owner or administrator. 238 (6) “Board” means the Board of Nursing Home and Assisted 239 Living Facility Administrators established under s. 468.1665. 240 (12)(11)“Extended congregate care” means acts beyond those 241 authorized in subsection (18) which(16)thatmay be performed 242 pursuant to part I of chapter 464 by persons licensed thereunder 243 while carrying out their professional duties, and other 244 supportive services which may be specified by rule. The purpose 245 of such services is to enable residents to age in place in a 246 residential environment despite mental or physical limitations 247 that might otherwise disqualify them from residency in a 248 facility licensed under this part. 249 (16) “Mental health professional” means an individual 250 licensed under chapter 458, chapter 459, chapter 464, chapter 251 490, or chapter 491 who provides mental health services as 252 defined in s. 394.67, or an individual who has a 4-year 253 baccalaureate degree with a concentration in mental health from 254 an accredited college or university and at least 5 years of 255 experience providing services that improve an individual’s 256 mental health or that treat mental illness. 257 Section 5. Section 429.07, Florida Statutes, is amended to 258 read: 259 429.07 Facility license required; fee.— 260 (1) The requirements of part II of chapter 408 apply to the 261 provision of services that require licensure pursuant to this 262 part and part II of chapter 408 and to entities licensed by or 263 applying for such licensure from the agency pursuant to this 264 part. A license issued by the agency is required in order to 265 operate an assisted living facility in this state. 266 (2) Separate licenses areshall berequired for facilities 267 maintained in separate premises, even though operated under the 268 same management. A separate license isshallnotberequired for 269 separate buildings on the same grounds. 270 (3) In addition to the requirements of s. 408.806, each 271 license granted by the agency must state the type of care for 272 which the license is granted. Licenses shall be issued for one 273 or more of the following categories of care: standard, extended 274 congregate care, limited nursing services, or limited mental 275 health. 276 (a) A standard license shall be issued to facilities 277 providing one or more of the personal services identified in s. 278 429.02. Such facilities may also employ or contract with a 279 person licensed under part I of chapter 464 to administer 280 medications and perform other tasks as specified in s. 429.255. 281 (b) An extended congregate care license shall be issued to 282 facilities providing, directly or through contract, services 283 beyond those authorized in paragraph (a), including services 284 performed by persons licensed under part I of chapter 464 and 285 supportive services, as defined by rule, to persons who would 286 otherwise be disqualified from continued residence in a facility 287 licensed under this part. 288 1. In order for extended congregate care services to be 289 provided, the agency must first determine that all requirements 290 established in law and rule are met and must specifically 291 designate, on the facility’s license, that such services may be 292 provided and whether the designation applies to all or part of 293 the facility. Such designation may be made at the time of 294 initial licensure or relicensure, or upon request in writing by 295 a licensee under this part and part II of chapter 408. The 296 notification of approval or the denial of the request shall be 297 made in accordance with part II of chapter 408. Existing 298 facilities qualifying to provide extended congregate care 299 services must have maintained a standard license and may not 300 have been subject to administrative sanctions during the 301 previous 2 years, or since initial licensure if the facility has 302 been licensed for less than 2 years, for any of the following 303 reasons: 304 a. A class I or class II violation; 305 b. Three or more repeat or recurring class III violations 306 of identical or similar resident care standards from which a 307 pattern of noncompliance is found by the agency; 308 c. Three or more class III violations that were not 309 corrected in accordance with the corrective action plan approved 310 by the agency; 311 d. Violation of resident care standards which results in 312 requiring the facility to employ the services of a consultant 313 pharmacist or consultant dietitian; 314 e. Denial, suspension, or revocation of a license for 315 another facility licensed under this part in which the applicant 316 for an extended congregate care license hadhasat least 25 317 percent ownership interest; or 318 f. Imposition of a moratorium pursuant to this part or part 319 II of chapter 408 or initiation of injunctive proceedings. 320 2. A facility that is licensed to provide extended 321 congregate care services mustshallmaintain a written progress 322 report on each person who receives services which describes the 323 type, amount, duration, scope, and outcome of services that are 324 rendered and the general status of the resident’s health. A 325 registered nurse, or appropriate designee, representing the 326 agency shall visit the facility at least quarterly to monitor 327 residents who are receiving extended congregate care services 328 and to determine if the facility is in compliance with this 329 part, part II of chapter 408, and relevant rules. One of the 330 visits may be in conjunction with the regular survey. The 331 monitoring visits may be provided through contractual 332 arrangements with appropriate community agencies. A registered 333 nurse shall serve as part of the team that inspects the 334 facility. The agency may waive one of the required yearly 335 monitoring visits for a facility that has been licensed for at 336 least 24 months to provide extended congregate care services, 337 if, during the inspection, the registered nurse determines that 338 extended congregate care services are being provided 339 appropriately, and if the facility has no class I or class II 340 violations and no uncorrected class III violations. The agency 341 must first consult with the long-term care ombudsman council for 342 the area in which the facility is located to determine if any 343 complaints have been made and substantiated about the quality of 344 services or care. The agency may not waive one of the required 345 yearly monitoring visits if complaints have been made and 346 substantiated. 347 3. A facility that is licensed to provide extended 348 congregate care services must: 349 a. Demonstrate the capability to meet unanticipated 350 resident service needs. 351 b. Offer a physical environment that promotes a homelike 352 setting, provides for resident privacy, promotes resident 353 independence, and allows sufficient congregate space as defined 354 by rule. 355 c. Have sufficient staff available, taking into account the 356 physical plant and firesafety features of the building, to 357 assist with the evacuation of residents in an emergency. 358 d. Adopt and follow policies and procedures that maximize 359 resident independence, dignity, choice, and decisionmaking in 360 order to permit residents to age in place,so that moves due to 361 changes in functional status are minimized or avoided. 362 e. Allow residents or, if applicable, a resident’s 363 representative, designee, surrogate, guardian, or attorney in 364 fact to make a variety of personal choices, participate in 365 developing service plans, and share responsibility in 366 decisionmaking. 367 f. Implement the concept of managed risk. 368 g. Provide, directly or through contract, the services of a 369 person licensed under part I of chapter 464. 370 h. In addition to the training mandated in s. 429.52 and 371 the specialized training provided in s. 429.521, provide 372 specialized training as defined by rule for facility staff. 373 4. A facility that is licensed to provide extended 374 congregate care services is exempt from the criteria for 375 continued residency set forth in rules adopted under s. 429.41. 376 A licensed facility must adopt its own requirements within 377 guidelines for continued residency set forth by rule. However, 378 the facility may not serve residents who require 24-hour nursing 379 supervision. A licensed facility that provides extended 380 congregate care services must also provide each resident with a 381 written copy of facility policies governing admission and 382 retention. 383 5. The primary purpose of extended congregate care services 384 is to allow residents, as they become more impaired, the option 385 of remaining in a familiar setting from which they would 386 otherwise be disqualified for continued residency. A facility 387 licensed to provide extended congregate care services may also 388 admit an individual who exceeds the admission criteria for a 389 facility with a standard license,if the individual is 390 determined appropriate for admission to the extended congregate 391 care facility. 392 6. Before the admission of an individual to a facility 393 licensed to provide extended congregate care services, the 394 individual must undergo a medical examination as provided in s. 395 429.26(4) and the facility must develop a preliminary service 396 plan for the individual. 397 7. IfWhena facility can no longer provide or arrange for 398 services in accordance with the resident’s service plan and 399 needs and the facility’s policy, the facility mustshallmake 400 arrangements for relocating the person in accordance with s. 401 429.28(1)(k). 402 8. Failure to provide extended congregate care services may 403 result in denial of extended congregate care license renewal. 404 (c) A limited nursing services license shall be issued to a 405 facility that provides services beyond those authorized in 406 paragraph (a) and as specified in this paragraph. 407 1. In order for limited nursing services to be provided in 408 a facility licensed under this part, the agency must first 409 determine that all requirements established in law and rule are 410 met and must specifically designate, on the facility’s license, 411 that such services may be provided. Such designation may be made 412 at the time of initial licensure or relicensure, or upon request 413 in writing by a licensee under this part and part II of chapter 414 408. Notification of approval or denial of such request shall be 415 made in accordance with part II of chapter 408. Existing 416 facilities qualifying to provide limited nursing services shall 417 have maintained a standard license and may not have been subject 418 to administrative sanctions that affect the health, safety, and 419 welfare of residents for the previous 2 years or since initial 420 licensure if the facility has been licensed for less than 2 421 years. 422 2. Facilities that are licensed to provide limited nursing 423 services shall maintain a written progress report on each person 424 who receives such nursing services, which report describes the 425 type, amount, duration, scope, and outcome of services that are 426 rendered and the general status of the resident’s health. A 427 registered nurse representing the agency shall visit such 428 facilities at least twice a year to monitor residents who are 429 receiving limited nursing services and to determine if the 430 facility is in compliance with applicable provisions of this 431 part, part II of chapter 408, and related rules. The monitoring 432 visits may be provided through contractual arrangements with 433 appropriate community agencies. A registered nurse shall also 434 serve as part of the team that inspects such facility. 435 3. A person who receives limited nursing services under 436 this part must meet the admission criteria established by the 437 agency for assisted living facilities. When a resident no longer 438 meets the admission criteria for a facility licensed under this 439 part, arrangements for relocating the person shall be made in 440 accordance with s. 429.28(1)(k), unless the facility is licensed 441 to provide extended congregate care services. 442 (4) In accordance with s. 408.805, an applicant or licensee 443 shall pay a fee for each license application submitted under 444 this part, part II of chapter 408, and applicable rules. The 445 amount of the fee shall be established by rule. 446 (a) The biennial license fee required of a facility is $300 447 per license, pluswithan additional fee of $50 per resident 448 based on the total licensed resident capacity of the facility, 449 except that annoadditional fee may notwillbe assessed for 450 beds designated for recipients of optional state supplementation 451 payments provided underfor ins. 409.212. The total fee may not 452 exceed $10,000. However, the biennial license fee for a licensed 453 facility that has one or more class I or class II violations 454 imposed by final order within the 2 years before licensure 455 renewal is $500 per license plus a fee of $55 per bed. The 456 increased fee amounts are in addition to any adjusted fee 457 amounts imposed pursuant to s. 408.805. The total fee for such 458 facilities may not exceed $20,000. The increased fees shall be 459 imposed for one licensure cycle, unless the facility has a class 460 I or class II violation during the next biennial inspection. 461 (b) In addition to the total fee assessed under paragraph 462 (a), the agency shall require facilities that are licensed to 463 provide extended congregate care services under this part to pay 464 an additional fee per licensed facility. The amount of the 465 biennial fee shall be $400 per license, with an additional fee 466 of $10 per resident based on the total licensed resident 467 capacity of the facility. 468 (c) In addition to the total fee assessed under paragraph 469 (a), the agency shall require facilities that are licensed to 470 provide limited nursing services under this part to pay an 471 additional fee per licensed facility. The amount of the biennial 472 fee shall be $250 per license, with an additional fee of $10 per 473 resident based on the total licensed resident capacity of the 474 facility. 475 (5) Counties or municipalities applying for licenses under 476 this part are exempt from the payment of license fees. 477 Section 6. Section 429.075, Florida Statutes, is amended to 478 read: 479 429.075 Limited mental health license.—An assisted living 480 facility that servesthree or moremental health residents must 481 obtain a limited mental health license. 482 (1) To obtain a limited mental health license, a facility 483 must hold a standard license as an assisted living facility and,484 must not have been subject to administrative sanctions during 485 the previous 2 years, or since initial licensure if the facility 486 has been licensed for less than 2 years, for any of the 487 following reasons: 488 (a) Two or more class I or class II violations; 489 (b) Three or more repeat or recurring class III violations 490 of identical or similar resident care standards from which a 491 pattern of noncompliance is found by the agency; 492 (c) Three or more class III violations that were not 493 corrected in accordance with the facility’s corrective action 494 plan approved by the agency; 495 (d) A violation of resident care standards which resulted 496 in requiring the facility to employ the consultant services of a 497 licensed pharmacist or a registered or licensed dietitian under 498 s. 429.42; 499 (e) Denial, suspension, or revocation of a license for 500 another facility licensed under this part in which the license 501 applicant had at least a 25 percent ownership interest; or 502 (f) Imposition of a moratorium pursuant to this part or 503 part II of chapter 408 or initiation of injunctive proceedings 504any current uncorrected deficiencies or violations, and must505ensure that, within 6 months after receiving a limited mental506health license, the facility administrator and the staff of the507facility who are in direct contact with mental health residents508must complete training of no less than 6 hours related to their509duties.Suchdesignation510 (2) Licensure to provide services to mental health 511 residents may be made at the time of initial licensure or 512 relicensure or upon request in writing by a licensee under this 513 part and part II of chapter 408. Notification of agency approval 514 or denial of such request mustshallbe made in accordance with 515 this part, part II of chapter 408, and applicable rules.This516training will be provided by or approved by the Department of517Children and Family Services.518 (3)(2)Facilities licensed to provide services to mental 519 health residents shall provide appropriate supervision and 520 staffing to provide for the health, safety, and welfare of such 521 residents. 522 (a) In addition to the general training or educational 523 requirements under this part or part II of chapter 468, as 524 applicable, each administrator and staff member who provides 525 regular or direct care to the residents of a facility licensed 526 to provide services to mental health residents must meet the 527 specialized limited mental health training requirements set 528 forth in s. 429.521. 529 (b) Effective July 1, 2013, an administrator of a facility 530 that has a limited mental health license, in addition to the 531 education requirements under part II of chapter 468, must have 532 also completed at least 6 semester credit hours of college-level 533 coursework relating to mental health. 534 (4)(3)A facility that holdshasa limited mental health 535 license must: 536 (a) Have a copy of each mental health resident’s community 537 living support plan and the cooperative agreement with the 538 mental health care services provider. The support plan and the 539 agreement may be combined. 540 (b) Have documentation that is provided by the Department 541 of Children and Family Services that each mental health resident 542 has been assessed and determined to be able to live in the 543 community in an assisted living facility with a limited mental 544 health license. 545 (c) Make the community living support plan available for 546 inspection by the resident, the resident’s legal guardian, the 547 resident’s health care surrogate, and other individuals who have 548 a lawful basis for reviewing this document. 549 (d) Assist the mental health resident in carrying out the 550 activities identified in the individual’s community living 551 support plan. 552 (5)(4)A facility that holdswitha limited mental health 553 license may enter into a cooperative agreement with a private 554 mental health provider. For purposes of the limited mental 555 health license, the private mental health provider may act as 556 the case manager. 557 (6) A mental health professional shall serve as part of the 558 team that inspects a facility that holds a limited mental health 559 license, and may conduct the inspection without other agency 560 representatives. A mental health professional representing the 561 agency shall visit the facility at least quarterly to monitor 562 residents who are receiving limited mental health services and 563 to determine if the facility is in compliance with this part, 564 part II of chapter 408, and relevant rules, and may send a 565 report to the agency reporting his or her findings. One of those 566 visits may be in conjunction with the agency’s regular survey. 567 The monitoring visits may be provided through a contractual 568 arrangement with an appropriate community agency. The agency may 569 waive one of the quarterly monitoring visits of a facility that 570 has had a mental health license for at least 2 years if, during 571 an inspection, the mental health professional determines that 572 mental health services are being provided appropriately and the 573 facility has had no class I or class II violation and no 574 uncorrected class III violation in the past 2 years. Before 575 waiving a monitoring visit, the agency must first consult with a 576 representative of the local long-term care ombudsman council for 577 the area in which the facility is located to determine if any 578 complaint has been made and the outcome of the complaint. The 579 agency may not waive one of the required monitoring visits if an 580 ombudsman referral was made to the agency which resulted in a 581 citation for a licensure violation. 582 Section 7. Subsection (4) of section 429.14, Florida 583 Statutes, is amended to read: 584 429.14 Administrative penalties.— 585 (4) The agency shall deny or revoke the license of an 586 assisted living facility that: 587 (a) Has two or more class I or class II violations that are 588 similar or identical to violations identified by the agency 589 during a survey, inspection, monitoring visit, or complaint 590 investigation occurring within the previous 2 years; or.591 (b) Committed a class I violation that caused the death of 592 a resident or an intentional or negligent act that, based on a 593 court’s findings, caused the death of a resident. 594 Section 8. Section 429.176, Florida Statutes, is amended to 595 read: 596 429.176Notice of change ofAdministrator license; 597 educational requirements; change of administrator; managers.— 598 (1) To be an administrator of an assisted living facility, 599 an applicant must meet the requirements under part I of chapter 600 468. 601 (2) A licensed administrator must complete a minimum of 18 602 hours of continuing education every 2 years and pass a short 603 examination that corresponds to each continuing education course 604 with a minimum score of 80 percent in order to demonstrate 605 receipt and comprehension of the training. The examination may 606 be offered online and any fees associated with the online 607 service must be borne by the participant. The license of a 608 facility whose administrator had not maintained these continuing 609 education requirements shall enter inactive status. 610 (3) The administrator of a facility that holds a limited 611 mental health license must have met the educational requirements 612 of s. 429.521(3). 613 (4) If, during the period for which a standard license is 614 issued, the facility owner changes administrators, the owner 615 must notify the agency of the change within 10 days and provide 616 documentation that the administrator is licensed or has been 617 granted a provisional licensewithin 90 days that the new618administrator has completed the applicable core educational619requirements under s.429.52. 620 (5) A manager of a facility who assumes responsibility for 621 the operation of the facility during the temporary absence of an 622 administrator must meet the core training requirements under s. 623 468.1685(9)(a) within 30 days after being employed as, or 624 becoming, a facility manager. 625 Section 9. Paragraphs (a) and (b) of subsection (2) of 626 section 429.178, Florida Statutes, are amended to read: 627 429.178 Special care for persons with Alzheimer’s disease 628 or other related disorders.— 629 (2)(a) Staff members, including administrators,An630individualwho areisemployed by a facility that provides 631 special care for residents with Alzheimer’s disease or other 632 related disorders, and who providehasregular or direct care to 633contact withsuch residents, must complete up to 4 hours of 634 initial dementia-specific training developed or approved by the 635 department. The training mustshallbe completed within 3 months 636 after beginning employmentand shall satisfy the core training637requirements of s.429.52(2)(g). 638 (b) A direct caregiver who is employed by a facility that 639 provides special care for residents with Alzheimer’s disease or 640 other related disorders, and who provides direct care to such 641 residents, must complete the required initial training and 4 642 additional hours of training developed or approved by the 643 department. The training mustshallbe completed within 6 months 6449 monthsafter beginning employmentand shall satisfy the core645training requirementsof s.429.52(2)(g). 646 Section 10. Subsections (1) and (2) of section 429.19, 647 Florida Statutes, are amended to read: 648 429.19 Violations; imposition of administrative fines; 649 grounds.— 650 (1) In addition to the requirements of part II of chapter 651 408 and s. 429.28(6), the agency shall impose an administrative 652 fine in the manner provided underinchapter 120 for the 653 violation of any provision of this part, part II of chapter 408, 654 and applicable rules by an assisted living facility;,for the 655 actions of any person subject to level 2 background screening 656 under s. 408.809;,for the actions of any facility employee;,or 657 for an intentional or negligent act seriously affecting the 658 health, safety, or welfare of a resident of the facility. 659 (2) Each violation of this part and adopted rules shall be 660 classified according to the nature of the violation and the 661 gravity of its probable effect on facility residents as provided 662 in s. 408.813. 663 (a) The agency shall indicate the classification on the 664 written notice of the violation as follows: 665 1.(a)For class “I” violations,are defined in s.408.813.666 the agency shall impose an administrative finefor a cited class667I violationin an amount not less than $5,000 and not exceeding 668 $10,000 for each violation. 669 2.(b)For class “II” violations,are defined in s.408.813.670 the agency shall impose an administrative finefor a cited class671II violationin an amount not less than $1,000 and not exceeding 672 $5,000 for each violation. 673 3.(c)For class “III” violations,are defined in s.674408.813.the agency shall impose an administrative finefor a675cited class III violationin an amount not less than $500 and 676 not exceeding $1,000 for each violation even if the violation is 677 corrected before the citation is issued. 678 4.(d)For class “IV” violations,are defined in s.408.813.679 the agency shall impose an administrative finefor a cited class680IV violationin an amount not less than $100 and not exceeding 681 $200 for each violation. 682 (b) The agency shall impose the maximum penalty for the 683 class of violation which results in the death of a resident. If 684 the facility is cited for a second or subsequent violation that 685 is in the same class as a prior violation that the facility has 686 been cited for at, or since, the last inspection, the agency 687 shall double the fine for the second or subsequent violation 688 even if the fine exceeds the maximum amount authorized. 689 Notwithstanding s. 408.813(c), if a facility is cited for ten or 690 more class III violations during an inspection or survey, the 691 agency shall impose a fine for each violation. 692 Section 11. Subsection (1) of section 429.23, Florida 693 Statutes, is amended to read: 694 429.23 Internal risk management and quality assurance 695 program; adverse incidents and reporting requirements.— 696 (1) As part of its administrative functions, an assisted 697 livingEveryfacility licensed under this part shallmay, as698part of its administrative functions, voluntarilyestablish a 699 risk management and quality assurance program, the purpose of 700 which is to assess resident care practices, facility incident 701 reports, deficiencies cited by the agency, adverse incident 702 reports, and resident grievances and develop plans of action to 703 correct and respond quickly to identify quality differences. 704 Section 12. Paragraph (b) of subsection (1) of section 705 429.256, Florida Statutes, is amended to read: 706 429.256 Assistance with self-administration of medication.— 707 (1) For the purposes of this section, the term: 708 (b) “Unlicensed person” means an individual not currently 709 licensed to practice nursing or medicine who is employed by or 710 under contract to an assisted living facility and who has 711 received training with respect to assisting with the self 712 administration of medication in an assisted living facility, as 713 provided under s. 429.521, before429.52prior toproviding such 714 assistance as described in this section. 715 Section 13. Subsection (2), paragraph (d) of subsection 716 (3), and subsection (6) of section 429.28, Florida Statutes, are 717 amended to read: 718 429.28 Resident bill of rights.— 719 (2) The administrator of a facility shall ensure that a 720 written notice of the rights, obligations, and prohibitions set 721 forth in this part is posted in a prominent place in each 722 facility and read or explained to residents who cannot read. The 723Thisnotice mustshallinclude the name, address, and telephone 724 numbers of the local ombudsman council and central abuse hotline 725 and, ifwhenapplicable, the Advocacy Center for Persons with 726 Disabilities, Inc., and the Florida local advocacy council, 727 where complaints may be lodged. The notice must state that the 728 subject matter of a complaint made to the Office of State Long 729 Term Care Ombudsman or a local long-term care ombudsman council 730 and the names and identities of the residents involved in the 731 complaint and the complainants are confidential pursuant to s. 732 400.0077. The facility must ensure a resident’s access to a 733 telephone to call the local ombudsman council, central abuse 734 hotline, Advocacy Center for Persons with Disabilities, Inc., 735 and the Florida local advocacy council. 736 (3) 737 (d) The agency shall conduct periodic followup inspections 738 to monitor the compliance of facilities having a history of 739 class I violations that threaten the health, safety, or security 740 of residents, and may conduct periodic followup inspections as 741 necessary to monitor the compliance of facilities havingwitha 742 history ofany classI,class II,or class III violations that 743 threaten the health, safety, or security of residents. 744 (6) AAnyfacility thatwhichterminates the residency of 745 an individual who participated in activities specified in 746 subsection (5) mustshallshow good cause in a court of 747 competent jurisdiction. If good cause is not shown, the agency 748 shall impose a fine of $2,500 in addition to any other penalty 749 assessed against the facility. 750 Section 14. Section 429.34, Florida Statutes, is amended to 751 read: 752 429.34 Right of entry and inspection.— 753 (1) In addition to the requirements of s. 408.811, aany754dulydesignated officer or employee of the department, the 755 Department of Children and Family Services, the Medicaid Fraud 756 Control Unit of the Office of the Attorney General, the state or 757 local fire marshal, or a member of the state or local long-term 758 care ombudsman council shall have the right to enter unannounced 759 upon and into the premises of any facility licensed pursuant to 760 this part in order to determine the state of compliance with the 761 provisions of this part, part II of chapter 408, and applicable 762 rules. Data collected by the state or local long-term care 763 ombudsman councils or the state or local advocacy councils may 764 be used by the agency in investigations involving violations of 765 regulatory standards. 766 (2) The agency is designated the central agency for 767 receiving and tracking complaints to ensure that allegations 768 regarding facilities are timely responded to and that licensure 769 enforcement action is initiated if warranted. Any other state 770 agency regulating, or providing services to residents of, 771 assisted living facilities must report any allegations or 772 complaints that have been substantiated or are likely to have 773 occurred to the agency as soon as reasonably possible. 774 (3) The agency shall have lead surveyors in each field 775 office who specialize in assessing assisted living facilities. 776 The lead surveyors shall provide initial and ongoing training to 777 surveyors who will be inspecting and monitoring facilities. The 778 lead surveyors shall ensure that consistent inspection and 779 monitoring assessments are conducted. 780 (4) The agency shall have one statewide lead surveyor who 781 specializes in assisted living facility inspections. The lead 782 surveyor shall coordinate communication between lead surveyors 783 of assisted living facilities throughout the state and ensure 784 statewide consistency in applying facility inspection laws and 785 rules. 786 Section 15. Paragraph (l) of subsection (1) and subsections 787 (2) and (5) of section 429.41, Florida Statutes, are amended to 788 read: 789 429.41 Rules establishing standards.— 790 (1) It is the intent of the Legislature that rules 791 published and enforced pursuant to this section shall include 792 criteria by which a reasonable and consistent quality of 793 resident care and quality of life may be ensured and the results 794 of such resident care may be demonstrated. Such rules shall also 795 ensure a safe and sanitary environment that is residential and 796 noninstitutional in design or nature. It is further intended 797 that reasonable efforts be made to accommodate the needs and 798 preferences of residents to enhance the quality of life in a 799 facility. The agency, in consultation with the department, may 800 adopt rules to administer the requirements of part II of chapter 801 408. In order to provide safe and sanitary facilities and the 802 highest quality of resident care accommodating the needs and 803 preferences of residents, the department, in consultation with 804 the agency, the Department of Children and Family Services, and 805 the Department of Health, shall adopt rules, policies, and 806 procedures to administer this part, which must include 807 reasonable and fair minimum standards in relation to: 808 (l) The establishment of specific policies and procedures 809 on resident elopement. Facilities shall conduct a minimum of two 810 resident elopement drills each year. All administrators and 811 direct care staff shall participate in the drills. Facilities 812 shall document the drills. Each calendar year, the agency shall 813 observe the elopement drills of 10 percent of the licensed 814 facilities in the state. The facilities must be randomly 815 selected by the agency and the elopement drills must coincide 816 with an inspection or survey conducted by the agency. If an 817 agency employee observes an elopement drill that does not meet 818 standards established by rule, the agency shall provide notice 819 of the deficiencies to the facility within 15 calendar days 820 after the drill. The facility shall submit a corrective action 821 plan to the agency within 30 calendar days after receiving such 822 notice. 823 (2) In adopting any rules pursuant to this part, the 824 department, in conjunction with the agency, shall make distinct 825 standards for facilities based upon facility size; the types of 826 care provided; the physical and mental capabilities and needs of 827 residents; the type, frequency, and amount of services and care 828 offered; and the staffing characteristics of the facility. Rules 829 developed pursuant to this section mayshallnot restrict the 830 use of shared staffing and shared programming in facilities that 831 are part of retirement communities that provide multiple levels 832 of care and otherwise meet the requirements of law and rule. The 833 department may require additional staffing for facilities that 834 have specialty licenses, but the additional staffing must 835 correlate with the number of residents receiving special care 836 and the type of special care required. Except for uniform 837 firesafety standards, the department shall adopt by rule 838 separate and distinct standards for facilities with 16 or fewer 839 beds and for facilities with 17 or more beds. The standards for 840 facilities with 16 or fewer beds mustshallbe appropriate for a 841 noninstitutional residential environment if, provided thatthe 842 structure is no more than two stories in height and all persons 843 who cannot exit the facility unassisted in an emergency reside 844 on the first floor. The department, in conjunction with the 845 agency, may make other distinctions among types of facilities as 846 necessary to enforce the provisions of this part. IfWhere847 appropriate, the agency shall offer alternate solutions for 848 complying with established standards, based on distinctions made 849 by the department and the agency relative to the physical 850 characteristics of facilities and the types of care offered 851therein. 852 (5) In order to allocate resources efficiently, the agency 853 shall conductmay usean abbreviated biennial standard licensure 854 inspection that consists of a review of key quality-of-care 855 standards in lieu of a full inspection in a facility that has a 856 good record of past performance. However, a full inspection must 857 be conducted in a facility that has a history of class I or 858 class II violations, uncorrected class III violations, confirmed 859 ombudsman council complaints, or confirmed licensure complaints, 860 within the previous licensure period immediately preceding the 861 inspection or if a potentially serious problem is identified 862 during the abbreviated inspection. The agency, in consultation 863 with the department, shall develop the key quality-of-care 864 standards with input from the State Long-Term Care Ombudsman 865 Council and representatives of provider groups for incorporation 866 into its rules. 867 Section 16. Subsection (1) of section 429.49, Florida 868 Statutes, is amended to read: 869 429.49 Resident records; penalties for alteration.— 870 (1) Any person who fraudulently alters, defaces, or 871 falsifies any medical or other record of an assisted living 872 facility, or causes or procures any such offense to be 873 committed, commits a misdemeanor of the firstseconddegree, 874 punishable as provided in s. 775.082 or s. 775.083. 875 Section 17. Section 429.515, Florida Statutes, is created 876 to read: 877 429.515 Preservice orientation.— 878 (1) Effective October 1, 2012, a new employee, including an 879 administrator, of an assisted living facility must attend a 880 preservice orientation provided by the facility which covers 881 topics that will enable the employee to relate and respond to 882 the residents of that facility. The orientation must be at least 883 2 hours in duration, be available in English and Spanish, and, 884 at a minimum, cover the following topics: 885 (a) Care of persons who have Alzheimer’s disease or other 886 related disorders. 887 (b) Deescalation techniques. 888 (c) Aggression control. 889 (d) Elopement prevention. 890 (e) Behavior management. 891 (2) Upon completion of the preservice orientation, the 892 employee must sign an affidavit, under penalty of perjury, 893 stating that the employee completed the orientation. The 894 administrator of the facility must maintain the signed affidavit 895 in the employee’s work file. 896 Section 18. Section 429.52, Florida Statutes, is amended to 897 read: 898 (Substantial rewording of section. See 899 s. 429.52, F.S., for present text.) 900 429.52 Staff member training; tutorial; continuing 901 education.— 902 (1) Staff members, other than administrators, providing 903 regular or direct care to residents must complete a staff 904 training curriculum developed by the board. The training must be 905 completed within 30 days after employment and is in addition to 906 the preservice orientation required under s. 429.515. Any cost 907 or fee associated with the training shall be borne by the 908 participant or the participant’s employer. 909 (2) Staff members, other than administrators, providing 910 regular or direct care to residents must complete an interactive 911 online tutorial developed by the board that demonstrates an 912 understanding of the training received under subsection (1). The 913 board shall provide a certificate to each staff member who 914 completes the tutorial. The certificate must be maintained in 915 the employee’s work file. 916 (3) Staff members, other than administrators, providing 917 regular or direct care to residents must participate in a 918 minimum of 8 hours of continuing education every 2 years as 919 developed by the board. The continuing education may be offered 920 through online courses and any fee associated with the online 921 service shall be borne by the participant or the participant’s 922 employer. 923 Section 19. Section 429.521, Florida Statutes, is created 924 to read: 925 429.521 Specialty training and education; examinations.— 926 (1) Administrators and staff members who provide regular or 927 direct care to residents of a facility that holds an extended 928 congregate care license must complete a minimum of 6 hours of 929 board-approved extended congregate care training within 30 days 930 after beginning employment. 931 (2) If a facility holds a limited nursing services license: 932 (a) The administrator must complete a minimum of 4 hours of 933 board-approved courses that train and educate administrators on 934 the special needs and care of those requiring limited nursing 935 services. 936 (b) Staff members providing regular and direct care to 937 residents receiving limited nursing services must complete a 938 minimum of 2 hours of courses that train and educate staff on 939 the special needs and care of those requiring limited nursing 940 services. The training must be completed within 30 days after 941 employment. 942 (3) Staff members who provide regular or direct care to 943 mental health residents and administrators who are employed by a 944 facility that holds a limited mental health license must 945 complete a minimum of 8 hours of board-approved mental health 946 training within 30 days after beginning employment. Within 30 947 days after completing such training, a staff member must 948 complete an online interactive tutorial related to the training 949 and receive a certificate of completion in order to demonstrate 950 an understanding of the training received. An administrator must 951 pass an examination related to the administrator’s training with 952 a minimum score of 80 percent. The participant or the 953 participant’s employer shall pay any fee associated with taking 954 the tutorial or examination. 955 (a) A staff member who does not complete the tutorial or an 956 administrator who fails the examination may not provide regular 957 or direct care to mental health residents until he or she 958 successfully completes the tutorial or passes the examination. 959 (b) An administrator who does not pass the examination 960 within 6 months after completing the mental health training may 961 not be an administrator of a facility that holds a limited 962 mental health license until the administrator achieves a passing 963 score. 964 (4) Staff, including administrators, who prepare or serve 965 food must receive a minimum of 1 hour of inservice training in 966 safe food handling practices within 30 days after beginning 967 employment. 968 (5) Staff members, including administrators, must receive 969 at least 1 hour of inservice training on the facility’s resident 970 elopement response policies and procedures within 30 days after 971 beginning employment. 972 (a) A copy of the facility’s resident elopement response 973 policies and procedures must be provided to staff members and 974 the administrator. 975 (b) Staff members and the administrator must demonstrate 976 understanding and competency in the implementation of the 977 elopement response policies and procedures. 978 (6) Staff members, including the administrator, involved 979 with the management of medications and the assistance with self 980 administration of medications under s. 429.256 must complete a 981 minimum of 4 additional hours of training provided by a 982 registered nurse, licensed pharmacist, or department staff 983 member. The board shall establish by rule the minimum 984 requirements of this training, including continuing education 985 requirements. 986 (7) Other facility staff members shall participate in 987 training relevant to their job duties as specified by board 988 rule. 989 Section 20. Section 429.522, Florida Statutes, is created 990 to read: 991 429.522 Assisted living training providers; certification.— 992 (1) Effective January 1, 2013, an individual seeking to 993 provide assisted living training in this state must be certified 994 by the board. The applicant must provide the board with proof of 995 completion of the minimum core training requirements, successful 996 passage of the assisted living facility administrator licensure 997 examination, and proof of compliance with any continuing 998 education requirements. 999 (2) A person seeking to be certified as a trainer must 1000 also: 1001 (a) Provide proof of completion of a 4-year baccalaureate 1002 degree from an accredited college or university and have worked 1003 in a management position in an assisted living facility for 3 1004 years after obtaining certification in core training courses; 1005 (b) Have worked in a management position in an assisted 1006 living facility for 5 years after obtaining certification in the 1007 core training courses and have 1 year of teaching experience as 1008 an educator or staff trainer for persons who work in an assisted 1009 living facility or another long-term care setting; 1010 (c) Have been previously employed as a trainer of core 1011 training courses for the department; 1012 (d) Have at least 5 years of employment with the agency as 1013 a surveyor of assisted living facilities; 1014 (e) Have at least 5 years of employment in a professional 1015 position in the agency’s assisted living unit; 1016 (f) Have at least 5 years of employment as an educator or 1017 staff trainer for persons working in an assisted living facility 1018 or another long-term care setting; 1019 (g) Have at least 5 years of employment as a trainer of 1020 core assisted living facility courses not directly associated 1021 with the department; 1022 (h) Have a 4-year baccalaureate degree from an accredited 1023 college or university in the areas of health care, gerontology, 1024 social work, education, or human services and at least 4 years 1025 of experience as an educator or staff trainer for persons 1026 working in an assisted living facility or another long-term care 1027 setting after receiving certification in core courses; or 1028 (i) Meet other qualification criteria as defined by rule of 1029 the board. 1030 (3) The board shall provide oversight of the assisted 1031 living training providers. The board shall adopt rules to 1032 establish requirements for trainer certification, disciplinary 1033 action that may be taken against a trainer, and a trainer 1034 decertification process. 1035 (4) If funding is available, by January 1, 2013, the board 1036 shall develop and maintain an electronic database, accessible to 1037 the public, which lists all persons holding certification as an 1038 assisted living trainer, including any history of violations. 1039 Assisted living trainers shall keep a record of individuals who 1040 complete training and shall submit the record to the board 1041 within 24 hours after the completion of a course in order for 1042 the board to include the information in the database. 1043 Section 21. Section 429.523, Florida Statutes, is created 1044 to read: 1045 429.523 Training and testing centers.—In addition to 1046 certified assisted living trainers under s. 429.522, training 1047 and testing centers approved by the board may conduct assisted 1048 living training or examinations under this part. 1049 (1) The board shall consider the following when reviewing a 1050 center applicant: 1051 (a) Whether the center will provide sufficient space for 1052 training. 1053 (b) The location of the center and whether another center 1054 already provides assisted living training or testing in the 1055 approximate area. 1056 (c) The fee to be charged by the center for providing such 1057 services. 1058 (d) Whether the center has sufficient staff who meet the 1059 qualifications for assisted living training providers under s. 1060 429.522. 1061 (e) Any other consideration that the board deems necessary 1062 to approve a center. 1063 (2) The board shall provide a certificate of approval to an 1064 applicant that meets with the board’s approval. The training and 1065 testing center shall keep the certificate on file as long as it 1066 provides assisted living training or examination services. 1067 (3) The board or the agency may inspect a center to 1068 determine whether the training or testing center meets law and 1069 rule requirements and may decertify a training and testing 1070 center that does not continue to meet such requirements. 1071 (4) An assisted living trainer employed by the training or 1072 testing center must perform the recordkeeping and reporting 1073 required under s. 429.522(4). 1074 Section 22. Section 429.54, Florida Statutes, is amended to 1075 read: 1076 429.54 Collection of information; local subsidy; 1077 interagency communication; facility reporting.— 1078 (1) To enable the department to collect the information 1079 requested by the Legislature regarding the actual cost of 1080 providing room, board, and personal care in assisted living 1081 facilities, the department mayis authorized toconduct field 1082 visits and audits of facilities asmay benecessary. The owners 1083 of randomly sampled facilities shall submit such reports, 1084 audits, and accountings of cost as the department may require by 1085 rule; however,provided thatsuch reports, audits, and 1086 accountings may not be more thanshall bethe minimum necessary 1087 to implement the provisions of this subsectionsection. Any 1088 facility selected to participate in the study shall cooperate 1089 with the department by providing cost of operation information 1090 to interviewers. 1091 (2) Local governments or organizations may contribute to 1092 the cost of care of local facility residents by further 1093 subsidizing the rate of state-authorized payment to such 1094 facilities. Implementation of local subsidy shall require 1095 departmental approval and mayshallnot result in reductions in 1096 the state supplement. 1097 (3) Subject to the availability of funds, the agency, the 1098 Department of Elderly Affairs, the Department of Children and 1099 Family Services, and the Agency for Persons with Disabilities 1100 shall develop or modify electronic systems of communication 1101 among state-supported automated systems to ensure that relevant 1102 information pertaining to the regulation of assisted living 1103 facilities and facility staff is timely and effectively 1104 communicated among agencies in order to facilitate the 1105 protection of residents. 1106 (4) All assisted living facilities shall submit twice a 1107 year electronic reports to the agency. 1108 (a) The reports must include the following information and 1109 must be submitted in accordance with a reporting cycle 1110 established by the agency by rule: 1111 1. The number of beds in the facility; 1112 2. The number of beds being occupied; 1113 3. The number of residents who are younger than 65 years of 1114 age, from 65 to 74 years of age, from 75 to 84 years of age, and 1115 85 years of age or older; 1116 4. The number of residents who are mental health residents, 1117 who are receiving extended congregate care, who are receiving 1118 limited nursing services, and who are receiving hospice care; 1119 5. If there is a facility waiting list, the number of 1120 individuals on the waiting list and the type of services or care 1121 that they require, if known; 1122 6. The number of residents receiving optional state 1123 supplementation; and 1124 7. The number of residents who are Medicaid recipients and 1125 the type of waiver used to fund each such resident’s care. 1126 (b) The agency must maintain electronically the information 1127 it receives and, at a minimum, use such information to track 1128 trends in resident populations and needs. 1129 (c) This subsection expires July 1, 2017. 1130 Section 23. Section 429.55, Florida Statutes, is created to 1131 read: 1132 429.55 Assisted living facility rating system.— 1133 (1) The agency, in consultation with the department, the 1134 Department of Children and Family Services, and the Office of 1135 State Long-Term Care Ombudsman, shall develop and adopt by rule 1136 a user-friendly assisted living facility rating system. 1137 (2) The rating system must be publicly available on the 1138 Internet in order to assist consumers in evaluating assisted 1139 living facilities and the services provided by such facilities. 1140 (3) The rating system must be based on resident 1141 satisfaction, the number and class of deficiencies for which the 1142 facility has been cited, agency inspection reports, the 1143 inspection reports of any other regulatory agency, assessments 1144 conducted by the ombudsman program pursuant to part of chapter 1145 400, and other criteria as determined by the agency. 1146 (4) The Internet home page for the rating system must 1147 include a link that allows consumers to complete a voluntary 1148 survey that provides feedback on whether the rating system is 1149 helpful and suggestions for improvement. 1150 (5) The agency may adopt rules as necessary to administer 1151 this section. 1152 Section 24. The Division of Statutory Revision is requested 1153 to rename part II of chapter 468, Florida Statutes, consisting 1154 of ss. 468.1635-468.1756, Florida Statutes, as “Nursing Home and 1155 Assisted Living Facility Administration.” 1156 Section 25. Section 468.1635, Florida Statutes, is amended 1157 to read: 1158 468.1635 Purpose.—The sole legislative purpose for enacting 1159 this partchapteris to ensure that every nursing home 1160 administrator and assisted living facility administrator 1161 practicing in this state meets minimum requirements for safe 1162 practice. It isthelegislative intent that nursing home 1163 administrators and assisted living facility administrators who 1164 fall below minimum competency or who otherwise present a danger 1165 to the publicshallbe prohibited from practicing in this state. 1166 Section 26. Section 468.1645, Florida Statutes, is amended 1167 to read: 1168 468.1645 Administrator license required.— 1169 (1) ANonursing homein the statemay not operate in this 1170 state unless it is under the management of a nursing home 1171 administrator, and, effective July 1, 2013, an assisted living 1172 facility may not operate in this state unless it is under the 1173 management of an assisted living facility administrator, who 1174 holds a currently valid license, provisional license, or 1175 temporary license. 1176 (2) Nothing in this part or in the rules adopted hereunder 1177shallrequire an administrator of any facility or institution 1178 operated by and for persons who rely exclusively upon treatment 1179 by spiritual means through prayer, in accordance with the creed 1180 or tenets of any organized church or religious denomination, to 1181 be licensed as a nursing home or assisted living facility 1182 administrator if the administrator is employed only to 1183 administer in such facilities or institutions for the care and 1184 treatment of the sick. 1185 Section 27. Section 468.1655, Florida Statutes, is 1186 reordered and amended to read: 1187 468.1655 Definitions.—As used in this part: 1188 (1) “Assisted living facility” means a facility licensed 1189 under part I of chapter 429. 1190 (2) “Assisted living facility administrator” means a person 1191 who is licensed to engage in the practice of assisted living 1192 facility administration in this state under the authority of 1193 this part. 1194 (3) “Assisted living facility administrator certification” 1195 means a professional credential awarded by a board-approved 1196 third-party credentialing entity to individuals who demonstrate 1197 core competency in the practice of assisted living facility 1198 administration and who meet the education, background screening, 1199 and other criteria specified by the board for licensure as an 1200 assisted living facility administrator. 1201 (4)(1)“Board” means the Board of Nursing Home and Assisted 1202 Living Facility Administrators. 1203 (5)(2)“Department” means the Department of Health. 1204 (7)(3)“Nursing home administrator” means a person who is 1205 licensed to engage in the practice of nursing home 1206 administration in this state under the authority of this part. 1207 (8) “Practice of assisted living facility administration” 1208 means any service requiring assisted living facility 1209 administration education, training, or experience and the 1210 application of such to the planning, organizing, staffing, 1211 directing, and controlling of the total management of an 1212 assisted living facility. A person is practicing or offering to 1213 practice assisted living facility administration if such person: 1214 (a) Practices any of the above services. 1215 (b) Holds himself or herself out as able to perform, or 1216 does perform, any form of assisted living facility 1217 administration by written or verbal claim, sign, advertisement, 1218 letterhead, or card; or in any other way represents himself or 1219 herself to be, or implies that he or she is, an assisted living 1220 facility administrator. 1221 (9)(4)“Practice of nursing home administration” means any 1222 service requiring nursing home administration education, 1223 training, or experience and the application of such to the 1224 planning, organizing, staffing, directing, and controlling of 1225 the total management of a nursing home. A person is practicing 1226 or offeringshall be construed to practice or to offerto 1227 practice nursing home administration if such personwho: 1228 (a) Practices any of the above services. 1229 (b) Holds himself or herself out as able to perform, or 1230 does perform, any form of nursing home administration by written 1231 or verbal claim, sign, advertisement, letterhead, or card; or in 1232 any other way represents himself or herself to be, or implies 1233 that he or she is, a nursing home administrator. 1234 (6)(5)“Nursing home” means an institution or facility 1235 licensed as such under part II of chapter 400. 1236 Section 28. Section 468.1665, Florida Statutes, is amended 1237 to read: 1238 468.1665 Board of Nursing Home and Assisted Living 1239 Facility Administrators; membership; appointment; terms.— 1240 (1) The Board of Nursing Home and Assisted Living Facility 1241 Administrators is created within the department and shall 1242 consist of elevensevenmembers, to be appointed by the Governor 1243 and confirmed by the Senate to a term of 4 years or for a term 1244 to complete an unexpired vacancy. 1245 (2) Three members of the board must be licensed nursing 1246 home administrators. Three members of the board must be licensed 1247 assisted living facility administrators. Two members of the 1248 board must be health care practitioners. ThreeThe remaining two1249 members of the board must be laypersons who are not, and have 1250 never been, nursing home or assisted living facility 1251 administrators or members of any health care profession or 1252 occupation, and at least one of these laypersons must be a 1253 resident of an assisted living facility. At least one member of 1254 the board must be 60 years of age or older. 1255 (3) A person may not be appointed as a member of the board 1256 if a conflict of interest exists, except that a nursing home 1257 administrator or an assisted living facility administrator who 1258 is appointed to the board may retain a financial interest in the 1259 institution or facility he or she administers at the time of 1260 appointmentOnly board members who are nursing home1261administrators may have a direct financial interest in any1262nursing home. 1263 (4) All provisions of chapter 456 relating to activities of 1264 regulatory boards shall apply. 1265 Section 29. Section 468.1685, Florida Statutes, is amended 1266 to read: 1267 468.1685 Powers and duties of board and department.—It is 1268 the function and duty of the board, together with the 1269 department, to: 1270 (1) Adopt rulespursuant to ss.120.536(1) and120.54to 1271 implement the provisions of this part conferring duties upon the 1272 board. 1273 (2) Develop, impose, and enforce specific standards within 1274 the scope of the general qualifications established by this part 1275 which must be met by individuals in order to receive licenses as 1276 nursing home or assisted living facility administrators. These 1277 standards shall be designed to ensure that nursing home and 1278 assisted living facility administrators are individuals of good 1279 character and otherwise suitable and, by training or experience 1280 in the field of health care facilityinstitutional1281 administration, qualified to serve as nursing home or assisted 1282 living facility administrators. 1283 (3) Develop by appropriate techniques, including 1284 examinations and investigations, a method for determining 1285 whether an individual meets such standards. 1286 (a) The board shall approve one or more third-party 1287 credentialing entities for the purpose of developing and 1288 administering assisted living facility administrator 1289 certification programs. A third-party credentialing entity must 1290 be a nonprofit organization that has met nationally recognized 1291 standards for developing and administering professional 1292 certification programs. 1293 (b) In order to obtain approval, a third-party 1294 credentialing entity must also: 1295 1. Establish professional requirements and standards that 1296 applicants must achieve in order to obtain an assisted living 1297 facility administrator certification and to maintain such 1298 certification. At a minimum, these requirements and standards 1299 must include completion of the requirements for assisted living 1300 facility administrators required in this part and in rules 1301 adopted by the board, including all education and continuing 1302 education requirements; 1303 2. Develop and apply core competencies and examination 1304 instruments according to nationally recognized certification and 1305 psychometric standards, and agree to assist the board with 1306 developing the training and testing materials under subsections 1307 (9), (10), and (11); 1308 3. Maintain a professional code of ethics and a 1309 disciplinary process that applies to all persons holding 1310 certification as an assisted living facility administrator; 1311 4. Maintain an Internet-based database, accessible to the 1312 public, of all persons holding an assisted living facility 1313 administrator certification, including any history of ethical 1314 violations; and 1315 5. Require continuing education and, at least, biennial 1316 certification renewal for persons holding an assisted living 1317 facility administrator certification. 1318 (4) Issue licenses to qualified individuals meeting the 1319 standards of the board and revoke or suspend licenses previously 1320 issued by the board ifwhenthe individual holding such license 1321 is determined to have failed toconformsubstantially conform to 1322 the requirements of such standards. 1323 (5) Establish by rule and carry out procedures, by rule,1324 designed to ensure that licensed nursing home or assisted living 1325 facility administratorswillcomply with the standards adopted 1326 by the board. 1327 (6) Receive, investigate, and take appropriate action with 1328 respect to any charge or complaint filed with the departmentto1329the effectthat a licensed nursing home or assisted living 1330 facility administrator has failed to comply with the 1331 requirements or standards adopted by the board. 1332 (7) Conduct a continuing study and investigation of nursing 1333 homes and assisted living facilities and the administrators of 1334 nursing homes and assisted living facilities in order to improve 1335 the standards imposed for the licensing of such administrators 1336 and the procedures and methods for enforcing such standards with 1337 respect to licensed administratorsof nursing homes who have1338been licensed as such. 1339 (8) Set up procedures by rule for advising and acting 1340 together with the departmentof Healthand other boards of other 1341 health professions in matters affecting procedures and methods 1342 for effectively enforcing the purpose of this part and the 1343 administration of chapters 400 and 429. 1344 (9) In consultation with the Agency for Health Care 1345 Administration, the Department of Elderly Affairs, and the 1346 Department of Children and Family Services, develop the 1347 following, which must be completed by an applicant for licensure 1348 as an assisted living facility administrator: 1349 (a) Assisted living facility administrator core training 1350 that includes at least 40 hours of training, is offered in 1351 English and Spanish, is reviewed at least annually by the board 1352 or its agent, and updated as needed to reflect changes in the 1353 law, rules, and best practices. The curriculum, at a minimum, 1354 must cover the following topics: 1355 1. State law and rules relating to assisted living 1356 facilities. 1357 2. Resident rights and the identification and reporting of 1358 abuse, neglect, and exploitation. 1359 3. The special needs of elderly persons, persons who have 1360 mental illness, and persons who have developmental disabilities 1361 and how to meet those needs. 1362 4. Nutrition and food service, including acceptable 1363 sanitation practices for preparing, storing, and serving food. 1364 5. Medication management, recordkeeping, and proper 1365 techniques for assisting residents who self-administer 1366 medication. 1367 6. Firesafety requirements, including procedures for fire 1368 evacuation drills and other emergency procedures. 1369 7. The care of persons who have Alzheimer’s disease and 1370 related disorders. 1371 8. Elopement prevention. 1372 9. Aggression and behavior management, deescalation 1373 techniques, and proper protocols and procedures relating to the 1374 Baker Act as provided in part I of chapter 394. 1375 10. Do-not-resuscitate orders. 1376 11. Infection control. 1377 12. Admission and continued residency. 1378 13. Phases of care and interacting with residents. 1379 14. Best practices in the industry. 1380 15. Business operations, including, but not limited to, 1381 human resources, financial management, and supervision of staff. 1382 (b) An assisted living facility administrator examination 1383 that tests the applicant’s knowledge and training of the core 1384 training topics listed in paragraph (a). The examination must be 1385 offered in English and Spanish, reviewed at least annually by 1386 the board or its agent, and updated as needed to reflect changes 1387 in the law, rules, and best practices. A minimum score of 80 1388 percent is required to demonstrate successful completion of the 1389 training requirements. 1390 (10) In consultation with the Agency for Health Care 1391 Administration, the Department of Elderly Affairs, and the 1392 Department of Children and Family Services, develop a continuing 1393 education curriculum, for licensed assisted living facility 1394 administrators. Administrators who are employed by extended 1395 congregate care, limited nursing services, or limited mental 1396 health licensees must complete additional credit hours as 1397 determined by the board. The board or its agent shall also 1398 develop a short examination that corresponds with each 1399 continuing education course and must be offered in English and 1400 Spanish. The board or its agent must review the continuing 1401 education curriculum and each examination at least annually, and 1402 update the curriculum and examinations as needed to reflect 1403 changes in the law, rules, and best practices. Continuing 1404 education must include topics similar to those of the core 1405 training in paragraph (9), and may include additional subject 1406 matter that enhances the knowledge, skills, and abilities of 1407 assisted living facility administrators, as adopted by rule. 1408 (11) In consultation with a panel of at least three mental 1409 health professionals, develop a limited mental health curriculum 1410 and examination, which must be completed by an assisted living 1411 facility administrator within 30 days after being employed by a 1412 limited mental health licensee. The examination must be offered 1413 in English and Spanish and must be available online. The board 1414 or its agent shall review the examination at least annually and 1415 update as needed. 1416 (12) In consultation with stakeholders, develop the 1417 standardized staff training curriculum required under s. 429.52 1418 for assisted living facility staff members, other than an 1419 administrator, who provide regular or direct care to residents. 1420 The curriculum must be reviewed at least annually by the board 1421 or its agent, and updated as needed to reflect changes in the 1422 law, rules, and best practices. The curriculum must include at 1423 least 20 hours of inservice training, with at least 1 hour of 1424 training per topic, covering at least the following topics: 1425 (a) Reporting major incidents. 1426 (b) Reporting adverse incidents. 1427 (c) Facility emergency procedures, including chain-of 1428 command and staff member roles relating to emergency evacuation. 1429 (d) Resident rights in an assisted living facility. 1430 (e) Recognizing and reporting resident abuse, neglect, and 1431 exploitation. 1432 (f) Resident behavior and needs. 1433 (g) Providing assistance with the activities of daily 1434 living. 1435 (h) Infection control. 1436 (i) Aggression and behavior management and deescalation 1437 techniques. 1438 (13) In consultation with the Agency for Health Care 1439 Administration, the Department of Elderly Affairs, the 1440 Department of Children and Family Services, and stakeholders, 1441 develop the interactive online tutorial required under s. 1442 429.52, which must be completed by assisted living facility 1443 staff members who provide regular or direct care to assisted 1444 living facility residents. The tutorial must be based on the 1445 training required under subsection (12). The board must offer 1446 the tutorial in English and Spanish and update the tutorial as 1447 needed, but at least annually. 1448 (14) In consultation with the Agency for Health Care 1449 Administration, the Department of Elderly Affairs, and the 1450 Department of Children and Family Services, develop the 1451 continuing education curriculum required under s. 429.52 for 1452 staff members of an assisted living facility who provide regular 1453 or direct care to assisted living facility residents. The board 1454 shall require additional credit hours for assisted living 1455 facility staff who are employed by extended congregate care, 1456 limited nursing services, or limited mental health licensees. 1457 The board or its agent must review the continuing education 1458 curriculum at least annually and update the curriculum as 1459 needed. Continuing education must include topics similar to 1460 those listed in subsection (12), and may include additional 1461 subject matter that enhances the knowledge, skills, and 1462 abilities of assisted living facility staff, as adopted by rule. 1463 (15) In consultation with a panel of at least three mental 1464 health professionals, develop the limited mental health 1465 curriculum and online interactive tutorial required under s. 1466 429.521(3), which must be completed by assisted living facility 1467 staff, other than the administrator, who provide regular and 1468 direct care to mental health residents. The board or its agents 1469 must ensure that the tutorial is offered in English and Spanish, 1470 and must be updated as needed, but at least annually. 1471 (16) Require and provide, or cause to be provided, the 1472 training or education of staff members of an assisted living 1473 facility beyond that which is required under this part if the 1474 board or department determines that there are problems in a 1475 facility which could be reduced through specific staff training 1476 or education. 1477 (17) Certify assisted living training providers who meet 1478 the qualifications under s. 429.522. 1479 (18) Approve testing and training centers pursuant to s. 1480 429.523. 1481 Section 30. Subsection (2) of section 468.1695, Florida 1482 Statutes, is amended and subsections (5) through (9) are added 1483 to that section, to read: 1484 468.1695 Licensure by examination; licensure by 1485 certification.— 1486 (2) The department shall examine each applicant for a 1487 nursing home administrator license who the board certifies has 1488 completed the application form and remitted an examination fee 1489 set by the board not to exceed $250 and who: 1490 (a)1. Holds a baccalaureate degree from an accredited 1491 college or university and majored in health care administration 1492 or has credit for at least 60 semester hours in subjects, as 1493 prescribed by rule of the board, which prepare the applicant for 1494 total management of a nursing home; and 1495 2. Has fulfilled the requirements of a college-affiliated 1496 or university-affiliated internship in nursing home 1497 administration or of a 1,000-hour nursing home administrator-in 1498 training program prescribed by the board; or 1499 (b)1. Holds a baccalaureate degree from an accredited 1500 college or university; and 1501 2.a. Has fulfilled the requirements of a 2,000-hour nursing 1502 home administrator-in-training program prescribed by the board; 1503 or 1504 b. Has 1 year of management experience allowing for the 1505 application of executive duties and skills, including the 1506 staffing, budgeting, and directing of resident care, dietary, 1507 and bookkeeping departments within a skilled nursing facility, 1508 hospital, hospice, assisted living facility with a minimum of 60 1509 licensed beds, or geriatric residential treatment program and, 1510 if such experience is not in a skilled nursing facility, has 1511 fulfilled the requirements of a 1,000-hour nursing home 1512 administrator-in-training program prescribed by the board. 1513 (5) Any person desiring to be licensed as an assisted 1514 living facility administrator must apply to the department, 1515 remit a fee set by the board not to exceed $500, and provide 1516 proof of a current and valid assisted living facility 1517 administrator certification. 1518 (6) An assisted living facility administrator certification 1519 must be issued by a board-approved third-party credentialing 1520 entity that certifies the individual: 1521 (a) Is at least 21 years old; 1522 (b) Holds a 4-year baccalaureate degree from an accredited 1523 college or university which includes some coursework in health 1524 care, gerontology, or geriatrics; a 4-year baccalaureate degree 1525 from an accredited college or university and has at least 2 1526 years of experience in direct care in an assisted living 1527 facility or nursing home; or a 2-year associate degree that 1528 includes coursework in health care, gerontology, or geriatrics 1529 and has at least 2 years of experience in direct care in an 1530 assisted living facility or nursing home; 1531 (c) Has completed a least 40 hours of core training; 1532 (d) Has passed an examination that documents core 1533 competencies in the training required for assisted living 1534 facility administrators prior to licensure with a minimum score 1535 of 80 percent; 1536 (e) Has completed background screening pursuant to ss. 1537 429.174 and 456.0365; and 1538 (f) Otherwise meets the requirements of this part and part 1539 I of chapter 429. 1540 (7) An assisted living facility administrator who is 1541 continuously employed as a facility administrator, or a nursing 1542 home administrator who is continuously employed as a nursing 1543 home administrator, for at least the 2 years before July 1, 1544 2012, is eligible for certification as an assisted living 1545 facility administrator without meeting the educational 1546 requirements of this section or taking the licensure examination 1547 if: 1548 (a) The core training under this part has been completed. 1549 (b) All continuing education requirements have been 1550 completed. 1551 (c) The applicant was not the administrator of a facility 1552 or nursing home that was cited for a class I or class II 1553 violation within the 2 years before July 1, 2012. 1554 (8) Other licensed professionals may be exempted from some 1555 or all of the training requirements of this section to be 1556 eligible for assisted living facility administrator 1557 certification, as determined by the board by rule. 1558 (9) A licensed assisted living facility administrator 1559 applying for relicensure must submit an application, remit 1560 applicable fees, and demonstrate that he or she has maintained 1561 his or her assisted living facility administrator certification 1562 that substantiates the individual has completed all continuing 1563 education and other requirements under this part to obtain 1564 licensure renewal. 1565 Section 31. Subsection (1) of section 468.1705, Florida 1566 Statutes, is amended to read: 1567 468.1705 Licensure by endorsement; temporary license.— 1568 (1) The department shall issue a nursing home administrator 1569 license by endorsement to ananyapplicant who, upon applying to 1570 the department and remitting a fee set by the board not to 1571 exceed $500, demonstrates to the board that he or she: 1572 (a) Meets one of the following requirements: 1573 1. Holds a valid active license to practice nursing home 1574 administration in another state of the United States if,1575provided thatthe current requirements for licensure in that 1576 state are substantially equivalent to, or more stringent than, 1577 current requirements in this state; or 1578 2. Meets the qualifications for licensure in s. 468.1695; 1579 and 1580 (b)1. Has successfully completed a national examination 1581 which is substantially equivalent to, or more stringent than, 1582 the examination given by the department; 1583 2. Has passed an examination on the laws and rules of this 1584 state governing the administration of nursing homes; and 1585 3. Has worked as a fully licensed nursing home 1586 administrator for 2 years within the 5-year period immediately 1587 preceding the application by endorsement. 1588 Section 32. Section 468.1725, Florida Statutes, is amended 1589 to read: 1590 468.1725 Inactive status.—An administrator’s license may 1591 become inactive if an administrator applies for inactive 1592 licensure status, does not pay licensure renewal fees on time, 1593 or does not complete continuing education courses within the 1594 requisite time. 1595 (1) If a license becomes inactive because: 1596 (a) The administrator applied for and was granted inactive 1597 licensure status, he or she must pay a reactivation fee in order 1598 to reactive the license. 1599 (b) The administrator failed to timely pay licensure 1600 renewal fees, he or she must pay the biennial renewal fee, a 1601 delinquency fee, and a reactivation fee. 1602 (c) The administrator did not timely complete continuing 1603 education requirements, his or her license may not be 1604 reactivated until satisfactory completion of the continuing 1605 education requirements. 1606 (2)(1)Unless otherwise prescribed in law, the board shall 1607 prescribe by rule continuing education requirements as a 1608 condition of reactivating a license. The continuing education 1609 requirements for reactivating a license may not exceed 20 1610 classroom hours for each year the license was inactive, in 1611 addition to completingcompletion ofthe number of hours 1612 required for renewal on the date the license became inactive. 1613 The board may not reactivate the license until he or she 1614 completes the continuing education requirements and pays a 1615 delinquency and reactivation fee. 1616 (3)(2)The board shall adopt rules relating to application 1617 procedures for inactive status, for the renewal of inactive 1618 licenses, and for the reactivation of licenses. The board shall 1619 prescribe by rule an application fee for inactive status,a1620renewal fee for inactive status,a delinquency fee, and a fee 1621 for the reactivation of a license.None ofThese fees may not 1622 exceed the biennial renewal fee established by the board for an 1623 active license. 1624(3) The department may not reactivate a license unless the1625inactive or delinquent licensee has paid any applicable biennial1626renewal or delinquency fee, or both, and a reactivation fee.1627 Section 33. Section 468.1735, Florida Statutes, is amended 1628 to read: 1629 468.1735 Provisional license.—The board may establish by 1630 rule requirements for issuance of a provisional license. A 1631 provisional license shall be issued only to fill a position of 1632 nursing home administrator that unexpectedly becomes vacant due 1633 to illness, sudden death of the administrator, or abandonment of 1634 position and shall be issued for one single period as provided 1635 by rule not to exceed 6 months. The department shall not issue a 1636 provisional license to any applicant who is under investigation 1637 in this state or another jurisdiction for an offense which would 1638 constitute a violation of s. 468.1745,ors. 468.1755, or s. 1639 429.55(4)(a), as applicable. Upon completion of the 1640 investigation relating to a nursing home administrator, the 1641 provisions of s. 468.1755 shall apply. The provisional license 1642 may be issued to a person who does not meet all of the licensing 1643 requirements established by this part, but the board shall by 1644 rule establish minimal requirements to ensure protection of the 1645 public health, safety, and welfare. The provisional license 1646 shall be issued to the person who is designated as the 1647 responsible person next in command in the event of the 1648 administrator’s departure. The board may set an application fee 1649 not to exceed $500 for a provisional license. 1650 Section 34. Section 468.1745, Florida Statutes, is amended 1651 to read: 1652 468.1745 Prohibitions; penalties.— 1653 (1) ANoperson may notshall: 1654 (a) Practice nursing home administration unless the person 1655 holds an active license to practice nursing home administration. 1656 (b) Use the name or title “nursing home administrator” if 1657whenthe person has not been licensed pursuant to this partact. 1658 (c) Present as his or her own the license of another. 1659 (d) Give false or forged evidence to the board or a member 1660 thereof for the purpose of obtaining a license. 1661 (e) Use or attempt to use a nursing home administrator’s 1662 license thatwhichhas been suspended or revoked. 1663 (f) Knowingly employ unlicensed persons in the practice of 1664 nursing home administration. 1665 (g) Knowingly conceal information relative to violations of 1666 this part. 1667 (2) A person may not: 1668 (a) Practice assisted living facility administration unless 1669 the person holds an active license to practice assisted living 1670 facility administration. 1671 (b) Use the name or title “assisted living facility 1672 administrator” if the person has not been licensed pursuant to 1673 this part. 1674 (c) Present as his or her own the license of another. 1675 (d) Give false or forged evidence to the board or a member 1676 thereof for the purpose of obtaining a license. 1677 (e) Use or attempt to use an assisted living facility 1678 administrator’s license that has been suspended or revoked. 1679 (f) Knowingly employ unlicensed persons in the practice of 1680 assisted living facility administration. 1681 (g) Knowingly conceal information relative to violations of 1682 this part. 1683 (3)(2)Any person who violates the provisions of this 1684 section is guilty of a misdemeanor of the second degree, 1685 punishable as provided in s. 775.082 or s. 775.083. 1686 Section 35. Section 468.1755, Florida Statutes, is amended 1687 to read: 1688 468.1755 Disciplinary proceedings.— 1689 (1) The following acts constitute grounds for denial of a 1690 nursing home administrator license or disciplinary action, as 1691 specified in s. 456.072(2): 1692 (a) Violation of any provision of s. 456.072(1) or s. 1693 468.1745(1). 1694 (b) Attempting to procure a license to practice nursing 1695 home administration by bribery, by fraudulent misrepresentation, 1696 or through an error of the department or the board. 1697 (c) Having a license to practice nursing home 1698 administration revoked, suspended, or otherwise acted against, 1699 including the denial of licensure, by the licensing authority of 1700 another state, territory, or country. 1701 (d) Being convicted or found guilty, regardless of 1702 adjudication, of a crime in any jurisdiction which relates to 1703 the practice of nursing home administration or the ability to 1704 practice nursing home administration. Any plea of nolo 1705 contendere shall be considered a conviction for purposes of this 1706 part. 1707 (e) Making or filing a report or record which the licensee 1708 knows to be false, intentionally failing to file a report or 1709 record required by state or federal law, willfully impeding or 1710 obstructing such filing, or inducing another person to impede or 1711 obstruct such filing. Such reports or records shall include only 1712 those which are signed in the capacity of a licensed nursing 1713 home administrator. 1714 (f) Authorizing the discharge or transfer of a resident for 1715 a reason other than those provided in ss. 400.022 and 400.0255. 1716 (g) Advertising goods or services in a manner which is 1717 fraudulent, false, deceptive, or misleading in form or content. 1718 (h) Fraud or deceit, negligence, incompetence, or 1719 misconduct in the practice of nursing home administration. 1720 (i) Violation of a lawful order of the board or department 1721 previously entered in a disciplinary hearing or failing to 1722 comply with a lawfully issued subpoena of the board or 1723 department. 1724 (j) Practicing with a revoked, suspended, inactive, or 1725 delinquent license. 1726 (k) Repeatedly acting in a manner inconsistent with the 1727 health, safety, or welfare of the patients of the facility in 1728 which he or she is the administrator. 1729 (l) Being unable to practice nursing home administration 1730 with reasonable skill and safety to patients by reason of 1731 illness, drunkenness, use of drugs, narcotics, chemicals, or any 1732 other material or substance or as a result of any mental or 1733 physical condition. In enforcing this paragraph, upon a finding 1734 of the State Surgeon General or his or her designee that 1735 probable cause exists to believe that the licensee is unable to 1736 serve as a nursing home administrator due to the reasons stated 1737 in this paragraph, the department shall have the authority to 1738 issue an order to compel the licensee to submit to a mental or 1739 physical examination by a physician designated by the 1740 department. If the licensee refuses to comply with such order, 1741 the department’s order directing such examination may be 1742 enforced by filing a petition for enforcement in the circuit 1743 court where the licensee resides or serves as a nursing home 1744 administrator. The licensee against whom the petition is filed 1745 shall not be named or identified by initials in any public court 1746 records or documents, and the proceedings shall be closed to the 1747 public. The department shall be entitled to the summary 1748 procedure provided in s. 51.011. A licensee affected under this 1749 paragraph shall have the opportunity, at reasonable intervals, 1750 to demonstrate that he or she can resume the competent practice 1751 of nursing home administration with reasonable skill and safety 1752 to patients. 1753 (m) Willfully or repeatedly violating any of the provisions 1754 of the law, code, or rules of the licensing or supervising 1755 authority or agency of the state or political subdivision 1756 thereof having jurisdiction of the operation and licensing of 1757 nursing homes. 1758 (n) Paying, giving, causing to be paid or given, or 1759 offering to pay or to give to any person a commission or other 1760 valuable consideration for the solicitation or procurement, 1761 either directly or indirectly, of nursing home usage. 1762 (o) Willfully permitting unauthorized disclosure of 1763 information relating to a patient or his or her records. 1764 (p) Discriminating with respect to patients, employees, or 1765 staff on account of race, religion, color, sex, or national 1766 origin. 1767 (q) Failing to implement an ongoing quality assurance 1768 program directed by an interdisciplinary team that meets at 1769 least every other month. 1770 (r) Violating any provision of this chapter or chapter 456, 1771 or any rules adopted pursuant thereto. 1772 (2) The board may enter an order denying nursing home 1773 administrator licensure or imposing any of the penalties in s. 1774 456.072(2) against any applicant for licensure or licensee who 1775 is found guilty of violating any provision of subsection (1) of 1776 this section or who is found guilty of violating any provision 1777 of s. 456.072(1). 1778 (3) The board may enter an order denying licensure or 1779 license renewal and may suspend or revoke the license of an 1780 assisted living facility administrator who is under 1781 investigation for, or who has committed, in this state or 1782 another jurisdiction, any of the following: 1783 (a) Attempting to procure a license to practice assisted 1784 living facility administration by bribery, fraudulent 1785 misrepresentation, or through an error of the agency or the 1786 board. 1787 (b) Having an license to practice assisted living facility 1788 administration revoked, suspended, or otherwise acted against, 1789 including the denial of licensure by the licensing authority of 1790 another state, territory, or country. 1791 (c) Being convicted or found guilty of, or entered a plea 1792 of nolo contendre, regardless of adjudication, to a crime in any 1793 jurisdiction which relates to the practice of assisted living 1794 facility administration. 1795 (d) Making or filing a report or record that the licensee 1796 knows to be false, intentionally failing to file a report or 1797 record required by state or federal law, willfully impeding or 1798 obstructing such filing, or inducing another person to impede or 1799 obstruct such filing. Such reports or records include only those 1800 that are signed in the capacity of a licensed assisted living 1801 facility administrator. 1802 (e) Advertising goods or services in a manner that is 1803 fraudulent, false, deceptive, or misleading in form or content. 1804 (f) Committing fraud or deceit or exhibiting negligence, 1805 incompetence, or misconduct in the practice of assisted living 1806 facility administration. 1807 (g) Violating a lawful order of the board or agency 1808 previously entered in a disciplinary hearing or failing to 1809 comply with a lawfully issued subpoena of the board or agency. 1810 (h) Repeatedly acting in a manner that is inconsistent with 1811 the health, safety, or welfare of the residents of the assisted 1812 living facility in which he or she is the administrator. 1813 (i) Being unable to practice assisted living facility 1814 administration with reasonable skill and safety to residents by 1815 reason of illness, drunkenness, use of drugs, narcotics, 1816 chemicals, or any other material or substance or as a result of 1817 any mental or physical condition. To enforce this subparagraph, 1818 upon a finding of the Secretary of Health Care Administration or 1819 his or her designee that probable cause exists to believe that 1820 the licensee is unable to serve as an assisted living facility 1821 administrator due to the reasons stated in this subparagraph, 1822 the agency may issue an order to compel the licensee to submit 1823 to a mental or physical examination by a physician designated by 1824 the agency. If the licensee refuses to comply with such order, 1825 the order may be enforced by filing a petition for enforcement 1826 in the circuit court where the licensee resides or serves as a 1827 facility administrator. The licensee against whom the petition 1828 is filed may not be named or identified by initials in any 1829 public court records or documents and the proceedings shall be 1830 closed to the public. The agency is entitled to the summary 1831 procedure pursuant to s. 51.011. At reasonable intervals, the 1832 licensee affected must be provided an opportunity to demonstrate 1833 that he or she can resume the competent practice of assisted 1834 living facility administration with reasonable skill and safety 1835 to residents. 1836 (j) Paying, giving, causing to be paid or given, or 1837 offering to pay or to give to any person a commission or other 1838 valuable consideration for the solicitation or procurement, 1839 directly or indirectly, of assisted living facility usage. 1840 (k) Willfully permitting unauthorized disclosure of 1841 information relating to a resident or his or her records. 1842 (l) Discriminating with respect to residents, employees, or 1843 staff members on account of race, religion, sex, or national 1844 origin. 1845 (m) Violating any provision of this part, part II of 1846 chapter 408, or rules adopted pursuant to this part. 1847 (4) The board shall revoke the license of an assisted 1848 living facility administrator who knowingly participates in 1849 intentional misconduct, or engages in conduct that constitutes 1850 gross negligence, and contributes to the death of a resident. 1851 (5)(3)The department shall reissue the license of a 1852 disciplined licensee upon certification by the board that the 1853 disciplined licensee has complied with all of the terms and 1854 conditions set forth in the final order. 1855 Section 36. Section 468.1756, Florida Statutes, is amended 1856 to read: 1857 468.1756 Statute of limitations.—An administrative 1858 complaint may only be filed pursuant to s. 456.073 for an act 1859 listed in s. 468.1755(1)(c)-(q)within 4 years afterfromthe 1860 time of the incident giving rise to the complaint, or within 4 1861 years afterfromthe time the incident is discovered or should 1862 have been discovered. 1863 Section 37. Assisted living facility streamlining task 1864 force.— 1865 (1) The Agency for Health Care Administration shall create 1866 a task force consisting of at least one representative from the 1867 agency, the Department of Elderly Affairs, the Department of 1868 Children and Family Services, the Department of Health, and the 1869 Office of State Long-Term Care Ombudsman. 1870 (2) The purpose of the task force is to determine whether 1871 agencies currently have overlapping regulatory responsibilities 1872 over assisted living facilities and whether increased efficiency 1873 and effectiveness may be realized by transferring, 1874 consolidating, eliminating, or modifying such oversight between 1875 agencies. 1876 (3) The task force shall meet at least three times and 1877 submit a report to the Governor, the President of the Senate, 1878 and the Speaker of the House of Representatives by January 1, 1879 2013, which includes the task force’s findings and 1880 recommendations pertaining to streamlining agency oversight and 1881 improving the effectiveness of regulatory functions. 1882 (4) The task force is terminated effective March 1, 2013. 1883 Section 38. By January 1, 2013, the Agency for Health Care 1884 Administration shall submit copies of all of its inspection 1885 forms used to inspect assisted living facilities to the Office 1886 of State Long-Term Care Ombudsman. The office shall create and 1887 act as the chair of a task force of up to 11 members, consisting 1888 of an ombudsman, one representative of a nonprofit assisted 1889 living facility, one representative of a for-profit assisted 1890 living facility, at least one resident or family member of a 1891 resident, other stakeholders, and one representative of the 1892 agency, the Department of Elderly Affairs, the Department of 1893 Children and Family Services, and the Department of Health, to 1894 review the inspection forms. The task force shall provide 1895 recommendations, if any, to modify the forms in order to ensure 1896 that inspections adequately assess whether the assisted living 1897 facilities are in compliance with the law, meet the needs of 1898 residents, and ensure resident safety. The task force must 1899 provide its recommendations, including explanations of its 1900 recommendations, to the agency within 90 days after receiving 1901 the inspection forms. The task force is terminated July 1, 2013. 1902 Section 39. This act shall take effect July 1, 2012.