Florida Senate - 2025 SB 890 By Senator Yarborough 4-01449-25 2025890__ 1 A bill to be entitled 2 An act relating to improving screening for and 3 treatment of blood clots; amending s. 385.102, F.S.; 4 revising legislative findings under the Chronic 5 Diseases Act; creating s. 385.213, F.S.; requiring the 6 Department of Health to establish, or contract to 7 establish, a statewide registry for a specified 8 purpose; requiring certain licensed facilities to 9 report specified information to the department for 10 inclusion in the registry; specifying limitations on 11 the use and publication of information from the 12 registry; providing that certain personal identifying 13 information is confidential and exempt from public 14 records requirements, with exceptions; specifying 15 requirements for the use of certain appropriated 16 funds; authorizing the department, by rule, to 17 classify facilities for purposes of certain reporting 18 requirements; requiring the department to exempt 19 certain facilities from certain reporting 20 requirements; providing applicability; creating s. 21 395.3042, F.S.; requiring certain licensed facilities 22 to arrange for the rendering of appropriate medical 23 attention for persons at risk for certain conditions; 24 specifying requirements for the manner in which such 25 facilities must provide such medical attention, 26 including admission, training, and practice policies; 27 amending s. 400.211, F.S.; revising requirements for 28 certain annual inservice training for certified 29 nursing assistants employed by nursing home 30 facilities; revising training requirements for certain 31 certified nursing assistants who may be delegated 32 tasks in nursing home facilities; amending s. 429.41, 33 F.S.; revising minimum standards for the care of 34 residents in assisted living facilities; amending s. 35 429.52, F.S.; revising requirements for the core 36 competency test for administrators of assisted living 37 facilities; providing an effective date. 38 39 Be It Enacted by the Legislature of the State of Florida: 40 41 Section 1.Subsection (1) of section 385.102, Florida 42 Statutes, is amended to read: 43 385.102Legislative intent.It is the finding of the 44 Legislature that: 45 (1)Chronic diseases exist in high proportions among the 46 people of this state. These chronic diseases include, but are 47 not limited to, heart disease, hypertension, diabetes, renal 48 disease, chronic obstructive pulmonary disease, cancer, chronic 49 critical illness, and genetic predisposition for developing 50 blood clots and pulmonary embolisms chronic obstructive lung 51 disease. These diseases are often interrelated, and they 52 directly and indirectly account for a high rate of death and 53 illness. 54 Section 2.Section 385.213, Florida Statutes, is created to 55 read: 56 385.213Blood clot and pulmonary embolism registry. 57 (1)The Department of Health shall establish, or contract 58 with a recognized medical organization in this state and its 59 affiliated institutions to establish, a statewide registry to 60 ensure blood clot and pulmonary embolism reports required under 61 this section are maintained and available for use in the course 62 of research for the purpose of reducing morbidity and mortality, 63 and liability of any kind or character for damages or other 64 relief may not arise or be enforced against any hospital by 65 reason of having provided such information or material to the 66 department for inclusion in the registry. 67 (2)Each facility licensed under chapter 395 or chapter 408 68 shall report to the department for inclusion in the registry all 69 of the following information, and as further specified by 70 department rule, for each instance of a blood clot, pulmonary 71 embolism, or deep vein thrombosis identified in a patient: 72 (a)The number of blood clots, pulmonary embolisms, and 73 deep vein thromboses identified and diagnosed. 74 (b)The age of the patient. 75 (c)The zip code of the patient. 76 (d)The sex of the patient. 77 (e)Whether the patient is a resident of a licensed nursing 78 home or assisted living facility. 79 (f)Whether the blood clot, pulmonary embolism, or deep 80 vein thrombosis was fatal. 81 (g)How the diagnosis was made, such as by using imaging 82 modalities. 83 (h)The treatment that was recommended for the blood clot, 84 pulmonary embolism, or deep vein thrombosis, as applicable. 85 (3)The department or contractor operating the registry may 86 use or publish information from the registry only for the 87 purpose of advancing medical research or medical education in 88 the interest of reducing morbidity or mortality, except that a 89 summary of such entries without any personal identifying 90 information may be released for general publication. Information 91 which discloses or could lead to the disclosure of personal 92 identifying information of any person whose condition or 93 treatment has been reported and studied is confidential and 94 exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I 95 of the State Constitution as specified in s. 119.0712(1), except 96 that: 97 (a)Such information may be released with the express 98 written consent of the person or his or her legally authorized 99 representative; 100 (b)The department or the contractor may contact 101 individuals for the purpose of epidemiologic investigation and 102 monitoring, provided such information that is confidential under 103 this section is not further disclosed; and 104 (c)The department may exchange data that includes personal 105 identifying information with any other governmental agency or 106 the contractor for the purpose of medical or scientific 107 research, provided such governmental agency or contractor does 108 not further disclose information that is confidential and 109 exempt. 110 (4)Funds appropriated for implementation of this section 111 must be used for establishing, administering, compiling, 112 processing, and providing biometric and statistical analyses to 113 the reporting facilities. Funds may also be used to ensure the 114 quality and accuracy of the information reported and to provide 115 management information to the reporting facilities. 116 (5)The department may, by rule, classify facilities for 117 purposes of reports made to the registry and specify the content 118 and frequency of the reports. In classifying facilities, the 119 department must exempt certain facilities from reporting blood 120 clot and pulmonary embolism information that was previously 121 reported to the department or retrieved from existing state 122 reports made to the department or the Agency for Health Care 123 Administration. 124 (6)This section does not apply to any facility whose 125 primary function is to provide psychiatric care to its patients. 126 Section 3.Section 395.3042, Florida Statutes, is created 127 to read: 128 395.3042Screening for blood clots, pulmonary embolisms, 129 and deep vein thrombosis in licensed facilities.Any licensed 130 facility that provides emergency room services, orthopedic 131 services, pregnancy services, or cancer treatment shall arrange 132 for the rendering of appropriate medical attention for persons 133 at risk of blood clots, pulmonary embolisms, or deep vein 134 thrombosis in the following manner: 135 (1)Upon admission to such a facility, a patient must be 136 assessed for risk of blood clots, pulmonary embolisms, and deep 137 vein thrombosis using a nationally recognized risk assessment 138 tool. 139 (2)The training of all staff in the facility must include 140 continuing education annually on how to recognize a blood clot, 141 pulmonary embolism, or deep vein thrombosis. 142 (3)The facility shall have established protocols for staff 143 to ensure that patients diagnosed with a life-threatening blood 144 clot, pulmonary embolism, or deep vein thrombosis are assessed 145 for various treatment options. 146 (4)The facility shall have an established policy in place 147 requiring a follow-up for all orthopedic patients who have 148 undergone lower extremity or pelvic surgery, to occur within 60 149 days after discharge. 150 (5)The facility shall have procedures in place to provide 151 ongoing blood clot risk assessment for patients who are at high 152 risk of developing blood clots, are pregnant, or are being 153 treated for cancer. 154 Section 4.Subsection (4) and paragraph (a) of subsection 155 (5) of section 400.211, Florida Statutes, are amended to read: 156 400.211Persons employed as nursing assistants; 157 certification requirement; qualified medication aide designation 158 and requirements. 159 (4)When employed by a nursing home facility for a 12-month 160 period or longer, a nursing assistant, to maintain 161 certification, shall submit to a performance review every 12 162 months and must receive regular inservice education based on the 163 outcome of such reviews. The inservice training must: 164 (a)Be sufficient to ensure the continuing competence of 165 nursing assistants and must meet the standard specified in s. 166 464.203(7); 167 (b)Include, at a minimum: 168 1.Techniques for assisting with eating and proper feeding; 169 2.Principles of adequate nutrition and hydration; 170 3.Techniques for assisting and responding to the 171 cognitively impaired resident or the resident with difficult 172 behaviors; 173 4.Techniques for caring for the resident at the end-of 174 life; and 175 5.Recognizing changes that place a resident at risk for 176 pressure ulcers and falls; and 177 6.Recognizing signs and symptoms of a blood clot, 178 pulmonary embolism, or deep vein thrombosis and techniques for 179 providing an emergency response; and 180 (c)Address areas of weakness as determined in nursing 181 assistant performance reviews and may address the special needs 182 of residents as determined by the nursing home facility staff. 183 184 Costs associated with this training may not be reimbursed from 185 additional Medicaid funding through interim rate adjustments. 186 (5)A nursing home, in accordance with chapter 464 and 187 rules adopted pursuant to this section, may authorize a 188 registered nurse to delegate tasks, including medication 189 administration, to a certified nursing assistant who meets the 190 requirements of this subsection. 191 (a)In addition to the initial 6-hour training course and 192 determination of competency required under s. 464.2035, to be 193 eligible to administer medication to a resident of a nursing 194 home facility, a certified nursing assistant must: 195 1.Hold a clear and active certification from the 196 Department of Health for a minimum of 1 year immediately 197 preceding the delegation; 198 2.Complete an additional 34-hour training course approved 199 by the Board of Nursing in medication administration and 200 associated tasks, including, but not limited to, blood glucose 201 level checks, dialing oxygen flow meters to prescribed settings, 202 and assisting with continuous positive airway pressure devices, 203 and identification of signs and symptoms of a blood clot and how 204 to assist with a response protocol; and 205 3.Demonstrate clinical competency by successfully 206 completing a supervised clinical practice in medication 207 administration and associated tasks conducted in the facility. 208 Section 5.Paragraph (g) of subsection (1) of section 209 429.41, Florida Statutes, is amended to read: 210 429.41Rules establishing standards. 211 (1)It is the intent of the Legislature that rules 212 published and enforced pursuant to this section shall include 213 criteria by which a reasonable and consistent quality of 214 resident care and quality of life may be ensured and the results 215 of such resident care may be demonstrated. Such rules shall also 216 promote a safe and sanitary environment that is residential and 217 noninstitutional in design or nature and may allow for 218 technological advances in the provision of care, safety, and 219 security, including the use of devices, equipment, and other 220 security measures related to wander management, emergency 221 response, staff risk management, and the general safety and 222 security of residents, staff, and the facility. It is further 223 intended that reasonable efforts be made to accommodate the 224 needs and preferences of residents to enhance the quality of 225 life in a facility. The agency, in consultation with the 226 Department of Children and Families and the Department of 227 Health, shall adopt rules to administer this part, which must 228 include reasonable and fair minimum standards in relation to: 229 (g)The care of residents provided by the facility, which 230 must include: 231 1.The supervision of residents; 232 2.The provision of personal services; 233 3.The provision of, or arrangement for, social and leisure 234 activities; 235 4.The assistance in making arrangements for appointments 236 and transportation to appropriate medical, dental, nursing, or 237 mental health services, as needed by residents; 238 5.The management of medication stored within the facility 239 and as needed by residents; 240 6.The dietary needs of residents; 241 7.Resident records; and 242 8.Internal risk management and quality assurance; and 243 9.Identification of residents who are at risk for 244 developing blood clots, and the treating facilitys response 245 protocols to help ensure access to timely treatment. 246 Section 6.Paragraph (h) is added to subsection (3) of 247 section 429.52, Florida Statutes, to read: 248 429.52Staff training and educational requirements. 249 (3)The agency, in conjunction with providers, shall 250 develop core training requirements for administrators consisting 251 of core training learning objectives, a competency test, and a 252 minimum required score to indicate successful passage of the 253 core competency test. The required core competency test must 254 cover at least the following topics: 255 (h)Identification of and responding to residents at high 256 risk of developing blood clots and pulmonary embolisms. 257 Section 7.This act shall take effect July 1, 2025.