| 15 | 15 | | An act relating to nursing homes; amending s. 400.021, 2 |
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| 16 | 16 | | F.S.; revising a definition; amending s. 400.23, F.S.; 3 |
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| 17 | 17 | | providing definitions; specifying functions that do 4 |
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| 18 | 18 | | not constitute direct care staffing hours for purposes 5 |
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| 19 | 19 | | of required nursing home staffing ratio s; requiring 6 |
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| 20 | 20 | | nursing home facilities to determine their direct care 7 |
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| 21 | 21 | | staffing needs based on the facility assessment and 8 |
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| 22 | 22 | | the individual needs of a resident based on the 9 |
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| 23 | 23 | | resident's care plan; revising nursing home staffing 10 |
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| 24 | 24 | | requirements; requiring nursing hom e facilities to 11 |
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| 25 | 25 | | maintain and report staffing information consistent 12 |
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| 26 | 26 | | with federal law; specifying that evidence of a 13 |
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| 27 | 27 | | facility's compliance with the minimum direct care 14 |
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| 28 | 28 | | staffing requirements is not admissible as evidence of 15 |
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| 29 | 29 | | compliance with certain federal re quirements; 16 |
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| 30 | 30 | | providing that certain paid feeding assistants and 17 |
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| 31 | 31 | | direct care staff count toward compliance with the 18 |
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| 32 | 32 | | overall direct care minimum staffing requirement; 19 |
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| 33 | 33 | | providing an exception; requiring certain direct care 20 |
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| 34 | 34 | | staff to complete a certain feeding as sistant training 21 |
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| 35 | 35 | | program; authorizing the Agency for Health Care 22 |
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| 36 | 36 | | Administration to adopt rules; amending s. 400.0234, 23 |
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| 37 | 37 | | F.S.; providing that certain information submitted to 24 |
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| 38 | 38 | | the agency is discoverable and may be admissible in 25 |
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| 46 | 46 | | Page 2 of 13 |
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| 47 | 47 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 48 | 48 | | |
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| 49 | 49 | | |
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| 50 | 50 | | |
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| 51 | 51 | | certain civil or administrative proceedings; amending 26 |
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| 52 | 52 | | s. 400.024, F.S.; providing that the transferee in a 27 |
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| 53 | 53 | | change of ownership of a facility is responsible and 28 |
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| 54 | 54 | | liable for any unsatisfied or undischarged adverse 29 |
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| 55 | 55 | | final judgements; requiring the licensee or transferor 30 |
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| 56 | 56 | | who submits an applica tion for a change of ownership 31 |
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| 57 | 57 | | to provide written notice to each pending claimant or 32 |
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| 58 | 58 | | the claimant's attorney; requiring such notice to be 33 |
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| 59 | 59 | | provided within a specified timeframe and by certain 34 |
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| 60 | 60 | | methods; providing that a claimant has a specified 35 |
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| 61 | 61 | | period to object to an application for a change of 36 |
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| 62 | 62 | | ownership; requiring the agency to consider any 37 |
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| 63 | 63 | | objection in its decision to approve or deny such 38 |
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| 64 | 64 | | application; authorizing a claimant to file a petition 39 |
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| 65 | 65 | | to enjoin a change of ownership under certain 40 |
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| 66 | 66 | | circumstances; defin ing the term "claimant"; amending 41 |
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| 67 | 67 | | s. 400.141, F.S.; revising provisions relating to a 42 |
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| 68 | 68 | | facility's failure to comply with minimum staffing 43 |
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| 69 | 69 | | requirements; conforming cross -references and 44 |
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| 70 | 70 | | provisions to changes made by the act; providing an 45 |
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| 71 | 71 | | effective date. 46 |
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| 72 | 72 | | 47 |
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| 73 | 73 | | Be It Enacted by the Legislature of the State of Florida: 48 |
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| 74 | 74 | | 49 |
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| 75 | 75 | | Section 1. Subsection (18) of section 400.021, Florida 50 |
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| 83 | 83 | | Page 3 of 13 |
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| 84 | 84 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 85 | 85 | | |
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| 86 | 86 | | |
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| 87 | 87 | | |
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| 88 | 88 | | Statutes, is amended to read: 51 |
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| 89 | 89 | | 400.021 Definitions. —When used in this part, unless the 52 |
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| 90 | 90 | | context otherwise requires, the term: 53 |
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| 91 | 91 | | (18) "Resident care plan" means a written comprehensive 54 |
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| 92 | 92 | | person-centered care plan developed in accordance with 42 55 |
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| 93 | 93 | | C.F.R. s. 483.21(b) by an interdisciplinary team within 7 days 56 |
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| 94 | 94 | | after completion of a comprehensive assessment and with 57 |
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| 95 | 95 | | participation by the resident or the resident's designee. The 58 |
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| 96 | 96 | | resident care plan must be reviewed and revised after each 59 |
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| 97 | 97 | | comprehensive assessment which may be a new admission 60 |
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| 98 | 98 | | assessment, an annual assessment, or an assessment after a 61 |
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| 99 | 99 | | significant change in status and after a quarterly revi ew 62 |
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| 100 | 100 | | assessment. A resident care plan includes measurable objectives 63 |
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| 101 | 101 | | and timeframes to meet the resident's medical, nursing, mental, 64 |
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| 102 | 102 | | and psychosocial needs and preferences and must describe the 65 |
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| 103 | 103 | | services to be furnished , maintained, and reviewed not less 66 |
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| 104 | 104 | | than quarterly by a registered nurse, with participation from 67 |
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| 105 | 105 | | other facility staff and the resident or his or her designee or 68 |
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| 106 | 106 | | legal representative, which includes a comprehensive assessment 69 |
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| 107 | 107 | | of the needs of an individual resident; the type and frequency 70 |
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| 108 | 108 | | of services required to provide the necessary care for the 71 |
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| 109 | 109 | | resident to attain or maintain the resident's highest 72 |
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| 110 | 110 | | practicable physical, mental, and psychosocial well -being; a 73 |
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| 111 | 111 | | listing of services provided within or outside the facility to 74 |
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| 112 | 112 | | meet those needs; and an e xplanation of service goals . 75 |
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| 120 | 120 | | Page 4 of 13 |
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| 121 | 121 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 122 | 122 | | |
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| 123 | 123 | | |
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| 124 | 124 | | |
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| 125 | 125 | | Section 2. Subsection (3) of section 400.23, Florida 76 |
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| 126 | 126 | | Statutes, is amended to read: 77 |
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| 127 | 127 | | 400.23 Rules; evaluation and deficiencies; licensure 78 |
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| 128 | 128 | | status.— 79 |
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| 129 | 129 | | (3)(a)1. As used in this subsection, the term: 80 |
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| 130 | 130 | | a. "Direct care staff" means persons who, through 81 |
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| 131 | 131 | | interpersonal contact with residents or resident care 82 |
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| 132 | 132 | | management, provide care and services to allow residents to 83 |
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| 133 | 133 | | attain or maintain the highest practicable physical, mental, 84 |
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| 134 | 134 | | and psychosocial well -being, including, but not limite d to, 85 |
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| 135 | 135 | | disciplines and professions that must be reported in accordance 86 |
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| 136 | 136 | | with 42 C.F.R. s. 483.70(q) in the categories of direct care 87 |
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| 137 | 137 | | services of nursing, dietary, therapeutic, and mental health. 88 |
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| 138 | 138 | | The term does not include a person whose primary duty is 89 |
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| 139 | 139 | | maintaining the physical environment of the facility, 90 |
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| 140 | 140 | | including, but not limited to, food preparation, laundry, and 91 |
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| 141 | 141 | | housekeeping. 92 |
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| 142 | 142 | | b. "Facility assessment" means a process to determine the 93 |
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| 143 | 143 | | staff competencies necessary to provide the level and types of 94 |
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| 144 | 144 | | care needed for the facility's resident population considering 95 |
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| 145 | 145 | | the types of diseases, conditions, physical and cognitive 96 |
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| 146 | 146 | | disabilities, overall acuity, and other facts pertinent to that 97 |
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| 147 | 147 | | resident population, and performed in accordance with 42 C.F.R. 98 |
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| 148 | 148 | | s. 483.70(e). 99 |
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| 149 | 149 | | 2. For purposes of this subsection, direct care staffing 100 |
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| 157 | 157 | | Page 5 of 13 |
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| 158 | 158 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 159 | 159 | | |
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| 160 | 160 | | |
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| 161 | 161 | | |
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| 162 | 162 | | hours do not include time spent on nursing administration, 101 |
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| 163 | 163 | | activities program administration, staff development, staffing 102 |
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| 164 | 164 | | coordination, and the administrative portion of the minimum 103 |
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| 165 | 165 | | data set and care plan coordination for Medicaid. 104 |
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| 166 | 166 | | (b)1. Each facility must determine its direct care 105 |
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| 167 | 167 | | staffing needs based on the facility assessment and the 106 |
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| 168 | 168 | | individual needs of a resident based on the resident's care 107 |
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| 169 | 169 | | plan. At a minimum, staffing The agency shall adopt ru les 108 |
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| 170 | 170 | | providing minimum staffing requirements for nursing home 109 |
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| 171 | 171 | | facilities. These requirements must include, for each facility , 110 |
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| 172 | 172 | | the following requirements : 111 |
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| 173 | 173 | | a. A minimum weekly average of certified nursing assistant 112 |
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| 174 | 174 | | and licensed nursing staffing combined of 3.6 hours of direct 113 |
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| 175 | 175 | | care by direct care staff per resident per day. As used in this 114 |
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| 176 | 176 | | sub-subparagraph, a week is defined as Sunday through Saturday. 115 |
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| 177 | 177 | | b. A minimum certified nursing assistant staffing of 2.0 116 |
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| 178 | 178 | | 2.5 hours of direct care by a certified nursing a ssistant per 117 |
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| 179 | 179 | | resident per day. A facility may not staff below one certified 118 |
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| 180 | 180 | | nursing assistant per 20 residents. 119 |
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| 181 | 181 | | c. A minimum licensed nursing staffing of 1.0 hour of 120 |
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| 182 | 182 | | direct care by a licensed nurse per resident per day. A 121 |
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| 183 | 183 | | facility may not staff below one licensed nurse per 40 122 |
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| 184 | 184 | | residents. 123 |
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| 185 | 185 | | 2. Nursing assistants employed under s. 400.211(2) may be 124 |
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| 186 | 186 | | included in computing the hours of direct care provided by 125 |
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| 194 | 194 | | Page 6 of 13 |
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| 195 | 195 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 196 | 196 | | |
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| 197 | 197 | | |
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| 198 | 198 | | |
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| 199 | 199 | | certified nursing assistants and may be included in computing 126 |
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| 200 | 200 | | the staffing ratio for certified nursing assistants if their 127 |
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| 201 | 201 | | job responsibilities include only nursing -assistant-related 128 |
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| 202 | 202 | | duties. 129 |
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| 203 | 203 | | 3. Each nursing home facility must document compliance 130 |
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| 204 | 204 | | with staffing standards as required under this paragraph and 131 |
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| 205 | 205 | | post daily the names of licensed nurses and certif ied nursing 132 |
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| 206 | 206 | | assistants staff on duty for the benefit of facility residents 133 |
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| 207 | 207 | | and the public. Facilities must maintain the records 134 |
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| 208 | 208 | | documenting compliance with minimum staffing standards for a 135 |
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| 209 | 209 | | period of 5 years and must report staffing in accordance with 136 |
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| 210 | 210 | | 42 C.F.R. s. 483.70(q). 137 |
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| 211 | 211 | | 4. The agency must shall recognize the use of licensed 138 |
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| 212 | 212 | | nurses for compliance with minimum staffing requirements for 139 |
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| 213 | 213 | | certified nursing assistants if the nursing home facility 140 |
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| 214 | 214 | | otherwise meets the minimum staffing requirements for license d 141 |
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| 215 | 215 | | nurses and the licensed nurses are performing the duties of a 142 |
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| 216 | 216 | | certified nursing assistant. Unless otherwise approved by the 143 |
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| 217 | 217 | | agency, licensed nurses counted toward the minimum staffing 144 |
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| 218 | 218 | | requirements for certified nursing assistants must exclusively 145 |
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| 219 | 219 | | perform the duties of a certified nursing assistant for the 146 |
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| 220 | 220 | | entire shift and not also be counted toward the minimum 147 |
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| 221 | 221 | | staffing requirements for licensed nurses. If the agency 148 |
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| 222 | 222 | | approved a facility's request to use a licensed nurse to 149 |
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| 223 | 223 | | perform both licensed nursing and certified nursing assistant 150 |
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| 231 | 231 | | Page 7 of 13 |
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| 232 | 232 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 233 | 233 | | |
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| 234 | 234 | | |
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| 235 | 235 | | |
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| 236 | 236 | | duties, the facility must allocate the amount of staff time 151 |
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| 237 | 237 | | specifically spent on certified nursing assistant duties for 152 |
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| 238 | 238 | | the purpose of documenting compliance with minimum staffing 153 |
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| 239 | 239 | | requirements for certified and licensed nursin g staff. The 154 |
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| 240 | 240 | | hours of a licensed nurse with dual job responsibilities may 155 |
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| 241 | 241 | | not be counted twice. 156 |
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| 242 | 242 | | 5. Evidence that a facility complied with the minimum 157 |
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| 243 | 243 | | direct care staffing requirements under subparagraph 1. is not 158 |
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| 244 | 244 | | admissible as evidence of compliance with the nursing services 159 |
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| 245 | 245 | | requirements under 42 C.F.R. s. 483.35 or 42 C.F.R. s. 483.70. 160 |
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| 246 | 246 | | (c)(b) Paid feeding assistants and direct care nonnursing 161 |
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| 247 | 247 | | staff, other than certified nursing assistants and licensed 162 |
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| 248 | 248 | | nurses, who have successfully completed the feeding assistant 163 |
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| 249 | 249 | | training program under s. 400.141(1)(v) and who provide 164 |
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| 250 | 250 | | providing eating assistance to residents shall not count toward 165 |
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| 251 | 251 | | compliance with overall direct care minimum staffing hours but 166 |
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| 252 | 252 | | not the hours of direct care required for certified nursing 167 |
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| 253 | 253 | | assistants or licensed nurses. Time spent by certified nursing 168 |
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| 254 | 254 | | assistants or licensed nurses on providing eating assistance to 169 |
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| 255 | 255 | | residents shall count toward the hours of direct care required 170 |
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| 256 | 256 | | for certified nursing assistants or licensed nurses standards. 171 |
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| 257 | 257 | | (d)(c) Licensed practical nurses licensed under chapter 172 |
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| 258 | 258 | | 464 who provide are providing nursing services in nursing home 173 |
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| 259 | 259 | | facilities under this part may supervise the activities of 174 |
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| 260 | 260 | | other licensed practical nurses, certified nursing assistants, 175 |
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| 268 | 268 | | Page 8 of 13 |
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| 269 | 269 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 270 | 270 | | |
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| 271 | 271 | | |
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| 272 | 272 | | |
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| 273 | 273 | | and other unlicensed personnel providing services in such 176 |
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| 274 | 274 | | facilities in accordance with rules adopted by the Board of 177 |
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| 275 | 275 | | Nursing. 178 |
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| 276 | 276 | | (e) The agency may adopt rules to implement this 179 |
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| 277 | 277 | | subsection. 180 |
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| 278 | 278 | | Section 3. Subsection (2) of section 400.0234, Florida 181 |
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| 279 | 279 | | Statutes, is renumbered a s subsection (3), and a new subsection 182 |
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| 280 | 280 | | (2) is added to that section, to read: 183 |
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| 281 | 281 | | 400.0234 Availability of facility records for 184 |
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| 282 | 282 | | investigation of resident's rights violations and defenses; 185 |
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| 283 | 283 | | penalty.— 186 |
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| 284 | 284 | | (2) Information submitted pursuant to s. 408.061(5) and 187 |
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| 285 | 285 | | (6) is discoverable and may be admissible in a civil action or 188 |
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| 286 | 286 | | an administrative action under this part or part II of chapter 189 |
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| 287 | 287 | | 408. 190 |
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| 288 | 288 | | Section 4. Subsection (4) of section 400.024, Florida 191 |
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| 289 | 289 | | Statutes, is amended, and subsection (5) is added to that 192 |
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| 290 | 290 | | section, to read: 193 |
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| 291 | 291 | | 400.024 Failure to satisfy a judgment or settlement 194 |
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| 292 | 292 | | agreement; required notification to claimants .— 195 |
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| 293 | 293 | | (4) If, After the agency is placed on notice pursuant to 196 |
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| 294 | 294 | | subsection (2), the following applies and: 197 |
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| 295 | 295 | | (a) If the license is subject to renewal, t he agency may 198 |
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| 296 | 296 | | deny the license renewal unless compliance with this section is 199 |
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| 297 | 297 | | achieved.; and 200 |
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| 305 | 305 | | Page 9 of 13 |
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| 306 | 306 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 307 | 307 | | |
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| 308 | 308 | | |
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| 309 | 309 | | |
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| 310 | 310 | | (b) If a change of ownership application for the facility 201 |
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| 311 | 311 | | at issue is submitted by the licensee, by a person or entity 202 |
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| 312 | 312 | | identified as having a controlling interest in the licensee, or 203 |
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| 313 | 313 | | by a related party, the agency shall deny the change of 204 |
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| 314 | 314 | | ownership application u nless compliance with this section is 205 |
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| 315 | 315 | | achieved. 206 |
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| 316 | 316 | | (c) If an adverse final judgement under subsection (1) is 207 |
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| 317 | 317 | | entered, but payment is not yet due and a change of ownership 208 |
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| 318 | 318 | | application for the facility at issue is submitted by the 209 |
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| 319 | 319 | | licensee, by a person or ent ity identified as having a 210 |
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| 320 | 320 | | controlling interest in the licensee, or by a related party, 211 |
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| 321 | 321 | | the adverse final judgment becomes the responsibility and 212 |
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| 322 | 322 | | liability of the transferee if the agency approves the change 213 |
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| 323 | 323 | | of ownership application. 214 |
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| 324 | 324 | | (5) If a change of o wnership application for the facility 215 |
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| 325 | 325 | | at issue is submitted by the licensee, by a person or entity 216 |
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| 326 | 326 | | identified as having a controlling interest in the licensee, or 217 |
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| 327 | 327 | | by a related party: 218 |
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| 328 | 328 | | (a) The licensee or transferor must provide written notice 219 |
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| 329 | 329 | | of the submission of the application to each pending claimant 220 |
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| 330 | 330 | | or the claimant's attorney of record, if applicable. The 221 |
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| 331 | 331 | | written notice must be provided within 14 days after the date 222 |
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| 332 | 332 | | the application is submitted to the agency. Notice must be 223 |
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| 333 | 333 | | provided by certified mail, return receipt requested, or other 224 |
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| 334 | 334 | | method that provides verification of receipt. 225 |
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| 342 | 342 | | Page 10 of 13 |
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| 343 | 343 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 344 | 344 | | |
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| 345 | 345 | | |
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| 346 | 346 | | |
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| 347 | 347 | | (b) A claimant has 30 days after the date of receipt of 226 |
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| 348 | 348 | | the written notice to object to the application if the claimant 227 |
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| 349 | 349 | | has reason to believe that the approval of the applic ation 228 |
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| 350 | 350 | | would facilitate a fraudulent transfer or allow the transferor 229 |
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| 351 | 351 | | to avoid financial responsibility for the claimant's pending 230 |
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| 352 | 352 | | claim. 231 |
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| 353 | 353 | | (c) The agency must consider any objection brought 232 |
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| 354 | 354 | | pursuant to this subsection in its decision to approve or deny 233 |
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| 355 | 355 | | an application for change of ownership under this part and part 234 |
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| 356 | 356 | | II of chapter 408. 235 |
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| 357 | 357 | | (d) If a claim is pending in arbitration at the time that 236 |
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| 358 | 358 | | the application for change of ownership is filed, the claimant 237 |
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| 359 | 359 | | may file a petition to enjoin the transfer in circuit court. 238 |
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| 360 | 360 | | 239 |
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| 361 | 361 | | As used in this subsection, "claimant" means a resident, the 240 |
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| 362 | 362 | | resident's family, or a personal representative who has 241 |
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| 363 | 363 | | notified the licensee or facility of a potential claim by 242 |
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| 364 | 364 | | written notice of intent or who has initiated an action, claim, 243 |
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| 365 | 365 | | or arbitration proceeding against the licensee or facility. 244 |
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| 366 | 366 | | Section 5. Paragraphs (g), (n), and (r) of subsection (1) 245 |
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| 367 | 367 | | of section 400.141, Florida Statutes, are amended to read: 246 |
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| 368 | 368 | | 400.141 Administration and management of nursing home 247 |
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| 369 | 369 | | facilities.— 248 |
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| 370 | 370 | | (1) Every licensed facility shall comply with all 249 |
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| 371 | 371 | | applicable standards and rules of the agency and shall: 250 |
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| 379 | 379 | | Page 11 of 13 |
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| 380 | 380 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 381 | 381 | | |
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| 382 | 382 | | |
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| 383 | 383 | | |
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| 384 | 384 | | (g) If the facility has a standard license, exceeds the 251 |
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| 385 | 385 | | minimum required hours of direct care provided by licensed 252 |
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| 386 | 386 | | nurses nursing and certified nursing assistants assistant 253 |
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| 387 | 387 | | direct care per resident per day, and is part of a continuing 254 |
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| 388 | 388 | | care facility licensed under chapter 651 or is a retirement 255 |
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| 389 | 389 | | community that offers other services pursuant to part III of 256 |
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| 390 | 390 | | this chapter or part I or part III of chapter 429 on a single 257 |
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| 391 | 391 | | campus, be allowed to share programming and staff. At the time 258 |
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| 392 | 392 | | of inspection, a continuing care facility or retirement 259 |
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| 393 | 393 | | community that uses this option must demonstrate through 260 |
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| 394 | 394 | | staffing records that minimum staffing requirements for the 261 |
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| 395 | 395 | | facility were met. Licensed nurses and certified nursing 262 |
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| 396 | 396 | | assistants who work in the facility may be used to provide 263 |
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| 397 | 397 | | services elsewhere on c ampus if the facility exceeds the 264 |
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| 398 | 398 | | minimum number of direct care hours required per resident per 265 |
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| 399 | 399 | | day and the total number of residents receiving direct care 266 |
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| 400 | 400 | | services from a licensed nurse or a certified nursing assistant 267 |
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| 401 | 401 | | does not cause the facility to viola te the staffing ratios 268 |
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| 402 | 402 | | required under s. 400.23(3)(b) s. 400.23(3)(a). Compliance with 269 |
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| 403 | 403 | | the minimum staffing ratios must be based on the total number 270 |
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| 404 | 404 | | of residents receiving direct care services, regardless of 271 |
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| 405 | 405 | | where they reside on campus. If the facility rec eives a 272 |
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| 406 | 406 | | conditional license, it may not share staff until the 273 |
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| 407 | 407 | | conditional license status ends. This paragraph does not 274 |
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| 408 | 408 | | restrict the agency's authority under federal or state law to 275 |
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| 416 | 416 | | Page 12 of 13 |
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| 417 | 417 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 418 | 418 | | |
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| 419 | 419 | | |
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| 420 | 420 | | |
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| 421 | 421 | | require additional staff if a facility is cited for 276 |
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| 422 | 422 | | deficiencies in care wh ich are caused by an insufficient number 277 |
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| 423 | 423 | | of certified nursing assistants or licensed nurses. The agency 278 |
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| 424 | 424 | | may adopt rules for the documentation necessary to determine 279 |
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| 425 | 425 | | compliance with this provision. 280 |
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| 426 | 426 | | (n) Comply with state minimum -staffing requirements: 281 |
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| 427 | 427 | | 1. A facility that has failed to comply with state 282 |
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| 428 | 428 | | minimum-staffing requirements for 48 2 consecutive hours days 283 |
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| 429 | 429 | | is prohibited from accepting new admissions until the facility 284 |
|---|
| 430 | 430 | | has achieved the minimum -staffing requirements for 6 285 |
|---|
| 431 | 431 | | consecutive days. For the pur poses of this subparagraph, any 286 |
|---|
| 432 | 432 | | person who was a resident of the facility and was absent from 287 |
|---|
| 433 | 433 | | the facility for the purpose of receiving medical care at a 288 |
|---|
| 434 | 434 | | separate location or was on a leave of absence is not 289 |
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| 435 | 435 | | considered a new admission. Failure by the facil ity to impose 290 |
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| 436 | 436 | | such an admissions moratorium is subject to a $1,000 fine. 291 |
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| 437 | 437 | | 2. A facility that does not have a conditional license may 292 |
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| 438 | 438 | | be cited for failure to comply with the standards in s. 293 |
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| 439 | 439 | | 400.23(3)(b)1.b. and c. s. 400.23(3)(a)1.b. and c. only if it 294 |
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| 440 | 440 | | has failed to meet those standards for 48 on 2 consecutive 295 |
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| 441 | 441 | | hours days or if it has failed to meet at least 97 percent of 296 |
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| 442 | 442 | | those standards on any one day. 297 |
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| 443 | 443 | | 3. A facility that has a conditional license must be in 298 |
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| 444 | 444 | | compliance with the standards in s. 400.23(3)(b) s. 299 |
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| 445 | 445 | | 400.23(3)(a) at all times. 300 |
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| 453 | 453 | | Page 13 of 13 |
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| 454 | 454 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 455 | 455 | | |
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| 456 | 456 | | |
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| 457 | 457 | | |
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| 458 | 458 | | (r) Maintain in the medical record for each resident a 301 |
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| 459 | 459 | | daily chart of direct care certified nursing assistant services 302 |
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| 460 | 460 | | provided to the resident. The direct care staff certified 303 |
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| 461 | 461 | | nursing assistant who is caring for the residen t must complete 304 |
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| 462 | 462 | | this record by the end of his or her shift. This record must 305 |
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| 463 | 463 | | indicate assistance with activities of daily living, assistance 306 |
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| 464 | 464 | | with eating, and assistance with drinking, and must record each 307 |
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| 465 | 465 | | offering of nutrition and hydration for those resid ents whose 308 |
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| 466 | 466 | | plan of care or assessment indicates a risk for malnutrition or 309 |
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| 467 | 467 | | dehydration. 310 |
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| 468 | 468 | | Section 6. This act shall take effect upon becoming a law. 311 |
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