Bill Text: FL S0896 | 2018 | Regular Session | Introduced
Bill Title: Nursing Homes and Related Health Care Facilities
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2018-03-10 - Died in Health Policy [S0896 Detail]
Download: Florida-2018-S0896-Introduced.html
Florida Senate - 2018 SB 896 By Senator Farmer 34-00537B-18 2018896__ 1 A bill to be entitled 2 An act relating to nursing homes and related health 3 care facilities; creating s. 366.042, F.S.; requiring 4 the Florida Public Service Commission to ensure that 5 public utilities effectively prioritize the 6 restoration of services to certain health care 7 facilities in the event of emergencies; amending s. 8 366.15, F.S.; deleting a provision specifying that 9 noncompliance with certain provisions related to 10 medically essential electric public utility service 11 does not form the basis for a cause of action against 12 a public utility; deleting a provision specifying that 13 a public utility’s failure to comply with certain 14 obligations does not constitute negligence; amending 15 s. 400.0060, F.S.; defining the term “autonomy”; 16 amending s. 400.0063, F.S.; establishing an Office of 17 the State Long-Term Care Ombudsman within the 18 Department of Elderly Affairs to administer the State 19 Long-Term Care Ombudsman Program; requiring the office 20 to contract with or make a grant to a private 21 nonprofit organization to manage the day-to-day 22 operations of the program; providing that the office 23 is not responsible for the licensing or certification 24 of long-term care facilities and prohibiting the 25 office from having a relationship with any such 26 facility; revising the appointment and removal 27 processes for the state ombudsman; requiring the state 28 ombudsman and the office’s legal advocate to register 29 as lobbyists; expanding the duties of the legal 30 advocate to include assisting the state ombudsman with 31 certain tasks related to the autonomy of the program; 32 amending s. 400.0065, F.S.; providing that a purpose 33 of the State Long-Term Care Ombudsman Program is to 34 support, rather than to administer, the state and 35 local councils; revising requirements for the annual 36 report required to be prepared by the State Long-Term 37 Care Ombudsman; amending s. 400.0067, F.S.; revising 38 the membership of the State Long-Term Care Ombudsman 39 Council; revising the number of consecutive terms that 40 may be served by the chair of the state council; 41 amending s. 400.0069, F.S.; requiring each state long 42 term care ombudsman district to convene a public 43 meeting at least monthly, rather than quarterly; 44 requiring representatives of the program, upon an 45 affirmative vote of the state council, to comment on 46 certain existing and proposed rules, regulations, and 47 policies; amending s. 400.0073, F.S.; authorizing 48 state and local councils to hold public hearings 49 related to certain investigations; requiring the legal 50 advocate to pursue legal remedies under certain 51 circumstances; amending s. 400.0074, F.S.; requiring 52 that onsite administrative assessments include the 53 review of the facility’s emergency management plan; 54 authorizing the office’s legal advocate to pursue 55 legal remedies for certain violations; requiring, 56 rather than authorizing, the department to adopt rules 57 implementing procedures for conducting onsite 58 administrative assessments of long-term care 59 facilities; amending s. 400.0077, F.S.; specifying 60 that the public discussion of administrative 61 assessments before the council is open to the public 62 and subject to ch. 119 and s. 286.011, F.S.; amending 63 s. 400.0078, F.S.; requiring the State Long-Term Care 64 Ombudsman Program to create and make available a 65 poster that contains certain information; requiring 66 each long-term care facility to display the State 67 Long-Term Care Ombudsman Program poster; creating s. 68 400.008, F.S.; providing legislative intent; requiring 69 the Office of the State Long-Term Care Ombudsman to 70 conduct unannounced quality-of-care evaluations of 71 certain health and long-term care facilities; 72 providing civil immunity from liability for certain 73 personnel of the office who participate in 74 evaluations; amending s. 400.0081, F.S.; requiring 75 long-term care facilities to timely provide to the 76 program, upon request, copies of records, policies, or 77 documents needed to complete an investigation or 78 assessment; requiring, rather than authorizing, the 79 department to adopt rules to establish procedures to 80 ensure access to facilities, residents, and records; 81 amending s. 400.0083, F.S.; revising a penalty; 82 requiring the Office of the State Long-Term Care 83 Ombudsman to investigate alleged violations of willful 84 interference with representatives of the State Long 85 Term Care Ombudsman Program and retaliation against 86 specified persons; requiring the office to report to 87 the Agency for Health Care Administration if it is 88 determined that a violation occurred; requiring the 89 agency to impose a fine for certain instances of 90 interference with or retaliation against the State 91 Long-Term Care Ombudsman Program; requiring the agency 92 to collect and transfer fines into the Quality of 93 Long-Term Care Facility Improvement Trust Fund; 94 requiring that the Division of Administrative Hearings 95 conduct a hearing if a determination of a violation is 96 contested; requiring the division to adopt rules; 97 requiring the administrative law judge to render a 98 decision within a specified timeframe after a hearing; 99 requiring the Chief Inspector General to investigate 100 any willful agency interference with the State Long 101 Term Care Ombudsman Program; amending s. 400.0087, 102 F.S.; requiring the nonprofit organization responsible 103 for the day-to-day operations of the State Long-Term 104 Care Ombudsman Program to consult with the state 105 ombudsman in developing and submitting a budget to the 106 department; limiting to a specified percentage the 107 amount that the department may divert from the federal 108 ombudsman appropriation to cover administrative costs 109 associated with the State Long-Term Care Ombudsman 110 Program; amending s. 400.0089, F.S.; specifying the 111 information that must be included in quarterly reports 112 required to be made by the State Long-Term Care 113 Ombudsman Program; requiring the State Long-Term Care 114 Ombudsman Program to include an analysis of such 115 information in an annual report; amending s. 400.0091, 116 F.S.; revising the subject areas that must be 117 addressed in the curriculum for initial and continuing 118 education training provided to representatives of the 119 State Long-Term Care Ombudsman Program; creating s. 120 400.0223, F.S.; defining the term “electronic 121 monitoring device”; requiring nursing homes to allow 122 residents, and certain individuals on their behalf, to 123 monitor the residents’ rooms through the use of 124 electronic monitoring devices; requiring nursing homes 125 to require persons who conduct such monitoring to post 126 a specific notice on the door to the residents’ rooms; 127 providing that such monitoring is voluntary and may be 128 conducted only at the request and expense of residents 129 or certain individuals on their behalf; prohibiting 130 nursing homes from making certain inquiries of 131 prospective residents or of the representatives of 132 prospective residents; prohibiting nursing homes from 133 rejecting applications for residency or removing 134 residents because of intent to use or use of 135 electronic monitoring devices; requiring nursing homes 136 to inform residents and specified individuals of the 137 resident’s right to conduct electronic monitoring; 138 requiring nursing homes to make reasonable physical 139 accommodations for electronic monitoring and to 140 provide a place for mounting and access to a power 141 source; authorizing nursing homes to require that 142 electronic monitoring be conducted in plain view; 143 authorizing nursing homes to require that a request to 144 conduct electronic monitoring be made in writing; 145 providing that audio or video recordings created 146 through the use of electronic monitoring may be 147 admitted into evidence in court or administrative 148 proceedings; providing criminal penalties for nursing 149 home administrators who violate specified provisions 150 relating to electronic monitoring; requiring prior 151 written consent from a resident or certain individuals 152 acting on the resident’s behalf before a nursing home 153 employee, officer, or agent may interfere with an 154 electronic monitoring device; providing a criminal 155 penalty for such interference without prior written 156 consent; imposing a civil penalty on nursing homes 157 that violate provisions related to electronic 158 monitoring; requiring the agency to transfer certain 159 funds into the Quality of Long-Term Care Facility 160 Improvement Trust Fund; repealing s. 400.0238, F.S., 161 relating to limitations on punitive damages; amending 162 s. 400.0239, F.S.; conforming provisions to changes 163 made by the act; creating s. 400.1185, F.S.; requiring 164 licensed facilities to establish internal resident 165 safety and quality-of-care coordinator programs; 166 specifying required components for the programs, 167 including development and implementation of a 168 reporting system for adverse incidents; requiring that 169 the reporting system require employees and agents to 170 report adverse incidents to the facility’s quality-of 171 care coordinator within a specified timeframe; 172 assigning responsibility for the programs to facility 173 governing boards; requiring facilities to hire a risk 174 manager to serve as the quality-of-care coordinator; 175 limiting the number of internal resident safety and 176 quality-of-care programs that coordinators may be 177 responsible for; encouraging the development of other 178 approaches to reducing adverse incidents and 179 violations of residents’ rights; requiring the agency 180 to adopt rules to administer the programs; requiring 181 that programs file all incident reports with a 182 designated employee of the facility, who must meet 183 certain requirements; providing immunity from civil 184 liability for individuals who file incident reports; 185 defining the term “adverse incident”; requiring 186 facilities to submit annual reports that must include 187 specified information to the agency by a specified 188 date; requiring the agency to review the information 189 submitted to determine whether disciplinary action is 190 warranted; requiring facilities to submit an incident 191 report and specified information to the agency within 192 a certain timeframe after they receive the report; 193 requiring the agency to determine within a certain 194 timeframe whether certain adverse incidents have 195 occurred; requiring the agency to require a written 196 plan of correction from facilities that violate 197 reporting requirements or provisions relating to the 198 internal resident safety and quality-of-care 199 coordinator programs; authorizing the agency to impose 200 specified civil penalties and administrative fines for 201 certain violations; requiring facilities to provide 202 the agency with access to certain facility records; 203 requiring the agency to review quality-of-care 204 programs as part of its licensure inspection process; 205 providing that, in the absence of intentional fraud, 206 quality-of-care coordinators may not be held 207 financially liable for actions taken within the scope 208 of their authority in connection with the 209 administration of this section; requiring the agency 210 to report to the appropriate regulatory board its 211 reasonable belief that the conduct of an agent or 212 employee of a licensed facility constitutes grounds 213 for disciplinary action; requiring the agency to 214 publish on its website an annual report card 215 containing specific information for licensed 216 facilities beginning on a specified date; requiring 217 the report card to include a specified statement; 218 amending s. 400.141, F.S.; requiring a licensed 219 nursing home to satisfy certain financial 220 requirements; providing that the required funds may 221 not be used for litigation costs or attorney fees in 222 certain circumstances; creating s. 400.1411, F.S.; 223 requiring nursing home facilities, as a condition of 224 licensure, to demonstrate to the satisfaction of the 225 agency and the Office of Insurance Regulation of the 226 Financial Services Commission the financial ability to 227 pay claims and costs arising out of the rendering of, 228 or the failure to render, care or services; providing 229 proper means of documentation; requiring insurers, 230 self-insurers, and risk retention groups to promptly 231 notify the agency and the office of cancellation or 232 nonrenewal of insurance; requiring a licensee to pay 233 the entire amount of a judgment, award, or settlement 234 and all accrued interest if a court orders a final 235 judgment against the licensee; providing that certain 236 deceptive, untrue, or fraudulent representations or 237 violations of financial requirements by any individual 238 or entity on behalf of a facility may result in 239 disciplinary action or a civil penalty with no 240 aggregate limit; requiring the agency to issue a 241 conditional license and authorizing the agency to 242 immediately suspend a license if a facility shows a 243 continuous pattern of violation of this section; 244 amending s. 400.19, F.S.; requiring the agency to 245 determine compliance with standards for electricity 246 and emergency power sources during routine unannounced 247 inspections of licensed nursing home facilities; 248 amending s. 400.191, F.S.; requiring facilities that 249 are on the Nursing Home Guide Watch List to 250 conspicuously post a sign that meets certain 251 requirements on each entrance to the facility for a 252 certain period of time; requiring the agency to cite 253 for a class I violation, place a facility on a 6-month 254 inspection cycle, and extend the duration of a 255 facility’s inclusion on the watch list for a specified 256 additional period of time under certain circumstances; 257 creating s. 400.226, F.S.; requiring licensed nursing 258 homes to comply with certain federal rules and 259 regulations; providing that a violation of such 260 federal regulations is considered negligence per se; 261 amending s. 400.23, F.S.; requiring the agency, in 262 consultation with the Department of Health and the 263 Department of Elderly Affairs, to adopt and enforce 264 rules requiring a licensed nursing home facility to 265 have adequate electrical equipment, an emergency power 266 source, and a supply of fuel which meet specified 267 criteria; requiring a comprehensive emergency plan to 268 provide for the evacuation of all residents of a 269 facility if the facility experiences a power outage 270 and is unable to sustain adequate emergency power; 271 requiring the agency to immediately impose a civil 272 penalty in a specified amount on a facility if it 273 determines that a resident of the facility died as the 274 result of abuse or neglect; amending s. 406.11, F.S.; 275 requiring medical examiners to determine the cause of 276 death when a person dies in their district in a 277 nursing home on the federal Special Focus Facility 278 list or on the Nursing Home Guide Watch List; amending 279 s. 406.13, F.S.; requiring a medical examiner to 280 notify and forward documentation to the state attorney 281 if he or she determines that a nursing home resident 282 died as a result of abuse, sexual abuse, or 283 negligence; requiring the state attorney to seat a 284 grand jury within 90 days after receipt of such 285 notification and investigate whether criminal charges 286 are warranted; repealing s. 429.298, F.S., relating to 287 limitations on punitive damages; amending s. 429.34, 288 F.S.; requiring the agency to determine compliance 289 with certain standards during the routine inspection 290 of a licensed assisted living facility, including 291 those related to construction and emergency power 292 sources; amending s. 429.41, F.S.; requiring the 293 Department of Elderly Affairs, in consultation with 294 the agency, the Department of Children and Families, 295 and the Department of Health, to adopt and enforce 296 rules relating to electricity and requiring a licensed 297 assisted living facility to maintain equipment 298 sufficient to provide an emergency power source and a 299 supply of fuel which meet specified criteria; 300 requiring that a comprehensive emergency plan provide 301 for the evacuation of all residents of a facility if 302 the facility experiences a power outage and is unable 303 to sustain emergency power as required; providing an 304 effective date. 305 306 Be It Enacted by the Legislature of the State of Florida: 307 308 Section 1. Section 366.042, Florida Statutes, is created to 309 read: 310 366.042 Power restoration priority.—The commission shall 311 ensure that public utilities have effectively prioritized, in 312 the event of an emergency, the restoration of services to 313 critical medical facilities, including nursing homes licensed 314 under part II of chapter 400 and assisted living facilities 315 licensed under part I of chapter 429. 316 Section 2. Subsection (11) of section 366.15, Florida 317 Statutes, is amended, and subsections (1) through (10) of that 318 section are republished, to read: 319 366.15 Medically essential electric public utility 320 service.— 321 (1) As used in this section, the term “medically essential” 322 means the medical dependence on electric-powered equipment that 323 must be operated continuously or as circumstances require as 324 specified by a physician to avoid the loss of life or immediate 325 hospitalization of the customer or another permanent resident at 326 the residential service address. 327 (2) Each public utility shall designate employees who are 328 authorized to direct an ordered continuation or restoration of 329 medically essential electric service. A public utility shall not 330 impose upon any customer any additional deposit to continue or 331 restore medically essential electric service. 332 (3)(a) Each public utility shall annually provide a written 333 explanation of the certification process for medically essential 334 electric service to each utility customer. Certification of a 335 customer’s electricity needs as medically essential requires the 336 customer to complete forms supplied by the public utility and to 337 submit a form completed by a physician licensed in this state 338 pursuant to chapter 458 or chapter 459 which states in medical 339 and nonmedical terms why the electric service is medically 340 essential. False certification of medically essential service by 341 a physician is a violation of s. 458.331(1)(h) or s. 342 459.015(1)(i). 343 (b) Medically essential service shall be recertified once 344 every 12 months. The public utility shall send the certified 345 customer by regular mail a package of recertification materials, 346 including recertification forms, at least 30 days prior to the 347 expiration of the customer’s certification. The materials shall 348 advise the certified customer that he or she must complete and 349 submit the recertification forms within 30 days after the 350 expiration of customer’s existing certification. If the 351 recertification forms are not received within this 30-day 352 period, the public utility may terminate the customer’s 353 certification. 354 (4) Each public utility shall certify a customer’s electric 355 service as medically essential if the customer completes the 356 requirements of subsection (3). 357 (5) Notwithstanding any other provision of this section, a 358 public utility may disconnect service to a residence whenever an 359 emergency may threaten the health or safety of a person, the 360 surrounding area, or the public utility’s distribution system. 361 The public utility shall act promptly to restore service as soon 362 as feasible. 363 (6) No later than 24 hours before any scheduled 364 disconnection of service for nonpayment of bills to a customer 365 who requires medically essential service, a public utility shall 366 attempt to contact the customer by telephone in order to provide 367 notice of the scheduled disconnection. If the customer does not 368 have a telephone number listed on the account or if the public 369 utility cannot reach the customer or other adult resident of the 370 premises by telephone by the specified time, the public utility 371 shall send a representative to the customer’s residence to 372 attempt to contact the customer, no later than 4 p.m. of the day 373 before scheduled disconnection. If contact is not made, however, 374 the public utility may leave written notification at the 375 residence advising the customer of the scheduled disconnection. 376 Thereafter, the public utility may disconnect service on the 377 specified date. 378 (7) Each public utility customer who requires medically 379 essential service is responsible for making satisfactory 380 arrangements with the public utility to ensure payment for such 381 service, and such arrangements must be consistent with the 382 requirements of the utility’s tariff. 383 (8) Each public utility customer who requires medically 384 essential service is solely responsible for any backup equipment 385 or power supply and a planned course of action in the event of a 386 power outage or interruption of service. 387 (9) Each public utility that provides electric service to 388 any customer who requires medically essential service shall 389 call, contact, or otherwise advise such customer of scheduled 390 service interruptions. 391 (10)(a) Each public utility shall provide information on 392 sources of state or local agency funding which may provide 393 financial assistance to the public utility’s customers who 394 require medically essential service and who notify the public 395 utility of their need for financial assistance. 396 (b)1. Each public utility that operates a program to 397 receive voluntary financial contributions from the public 398 utility’s customers to provide assistance to persons who are 399 unable to pay for the public utility’s services shall maintain a 400 list of all agencies to which the public utility distributes 401 such funds for such purposes and shall make the list available 402 to any such person who requests the list. 403 2. Each public utility that operates such a program shall: 404 a. Maintain a system of accounting for the specific amounts 405 distributed to each such agency, and the public utility and such 406 agencies shall maintain a system of accounting for the specific 407 amounts distributed to persons under such respective programs. 408 b. Train its customer service representatives to assist any 409 person who possesses a medically essential certification as 410 provided in this section in identifying such agencies and 411 programs. 412(11) Nothing in this act shall form the basis for any cause413of action against a public utility. Failure to comply with any414obligation created by this act does not constitute evidence of415negligence on the part of the public utility.416 Section 3. Present subsections (3) through (14) of section 417 400.0060, Florida Statutes, are redesignated as subsections (4) 418 through (15), respectively, and a new subsection (3) is added to 419 that section, to read: 420 400.0060 Definitions.—When used in this part, unless the 421 context clearly dictates otherwise, the term: 422 (3) “Autonomy” means the freedom of residents from threats 423 of interference, coercion, retaliation, or intimidation as they 424 reside and receive care in a long-term care facility and as 425 advocated for by the Office of the State Long-Term Care 426 Ombudsman. 427 Section 4. Section 400.0063, Florida Statutes, is amended 428 to read: 429 400.0063 Establishment of the State Long-Term Care 430 Ombudsman Program; designation of ombudsman and legal advocate.— 431 (1) The Office ofThere is createdthe State Long-Term Care 432 Ombudsman is established withinProgram inthe Department of 433 Elderly Affairs to administer the State Long-Term Care Ombudsman 434 Program. The office shall enter into a contract with, or make a 435 grant to, a private nonprofit organization to oversee the day 436 to-day operations of the program. The office does not have any 437 responsibility with regard to the licensing or certification of 438 long-term care facilities and may not have a relationship with 439 any long-term care facility. 440 (2)(a) The State Long-Term Care Ombudsman Program shall be 441 headed by the State Long-Term Care Ombudsman, who shall serve on 442 a full-time basis and shall personally, or through 443 representatives of the program, carry out theitspurposes and 444 functions of the program in accordance with state and federal 445 law. 446 (b) A five-member selection panel appointed by the 447 Secretary of Elderly Affairs shall appoint the state ombudsman, 448 who must haveshall be appointed byand shall serve at the449pleasure ofthe Secretary of Elderly Affairs. The secretary450shall appoint a person who hasexpertise in the operation of a 451 nonprofit organization and at least 5 years of experience inthe452fieldsoflong-term care residentandadvocacy. The state 453 ombudsman may be removed from office only by a two-thirds vote 454 of the state council with the consent of the secretary and the 455 private nonprofit organization that oversees the operations of 456 the program. Theto serve asstate ombudsman shall register as a 457 lobbyist pursuant to s. 11.045. 458 (3)(a) The state ombudsman shall select a person who is a 459 member in good standing of The Florida Bar to serve in the 460 position ofThere is created in the office the position oflegal 461 advocate, which is created within the office. The legal 462 advocate, who shallbe selected by andserve at the pleasure of 463 the state ombudsman, shall register as a lobbyist pursuant to s. 464 11.045andshallbe a member in good standing of The Florida465Bar. 466 (b) The duties of the legal advocateshallinclude, but are 467 notbelimited to: 468 1. Assisting the state ombudsman in carrying out the duties 469 of the office with respect to the abuse, neglect, exploitation, 470 or violation of rights of residents of long-term care 471 facilities. 472 2. Assisting the representatives of the State Long-Term 473 Care Ombudsman Program in carrying out their responsibilities 474 under this part. 475 3. Pursuing administrative, legal, and other appropriate 476 remedies on behalf of residents. 477 4. Serving as legal counsel to the representatives of the 478 State Long-Term Care Ombudsman Program in any suit or other 479 legal action that is initiated in connection with the 480 performance of the official duties of the representatives of the 481 State Long-Term Care Ombudsman Program. 482 5. Assisting the state ombudsman in ensuring that the 483 program is operated autonomously; without conflict of interest; 484 and without interference, coercion, or retaliation against those 485 associated with the operation of the program. 486 Section 5. Paragraph (f) of subsection (1) and paragraph 487 (h) of subsection (2) of section 400.0065, Florida Statutes, are 488 amended to read: 489 400.0065 State Long-Term Care Ombudsman Program; duties and 490 responsibilities.— 491 (1) The purpose of the State Long-Term Care Ombudsman 492 Program is to: 493 (f) SupportAdministerthe state and local councils. 494 (2) The State Long-Term Care Ombudsman has the duty and 495 authority to: 496 (h) Prepare an annual report describing the activities 497 carried out by the office, the state council, the districts, and 498 the local councils in the year for which the report is prepared. 499 The state ombudsman shall submit the report to the secretary, 500 the United States Assistant Secretary for Aging, the Governor, 501 the President of the Senate, the Speaker of the House of 502 Representatives, the Secretary of Children and Families, and the 503 Secretary of the Agency for Health Care Administration at least 504 30 days before the convening of the regular session of the 505 Legislature. The report must, at a minimum: 506 1. Contain and analyze data collected concerning complaints 507 about and conditions in long-term care facilities and the 508 disposition of such complaints. 509 2. Evaluate the problems experienced by residents. 510 3. Analyze the successes of the State Long-Term Care 511 Ombudsman Program during the preceding year, including an 512 assessment of how successfully the program has carried out its 513 responsibilities under the Older Americans Act and the laws of 514 this state. 515 4. Provide recommendations for policy, regulatory, and 516 statutory changes designed to solve identified problems; resolve 517 residents’ complaints; improve residents’ lives and quality of 518 care; protect residents’ rights, health, safety, and welfare; 519 and remove any barriers to the optimal operation of the State 520 Long-Term Care Ombudsman Program. 521 5. Contain recommendations from the State Long-Term Care 522 Ombudsman Council, local councils, resident and family councils, 523 and consumer advocacy groups regarding program functions and 524 activities and recommendations for policy, regulatory, and 525 statutory changes designed to protect residents’ rights, health, 526 safety, and welfare. 527 6. Contain any relevant recommendations from the 528 representatives of the State Long-Term Care Ombudsman Program 529 regarding program functions and activities. 530 Section 6. Subsection (3) and paragraph (c) of subsection 531 (4) of section 400.0067, Florida Statutes, are amended to read: 532 400.0067 State Long-Term Care Ombudsman Council; duties; 533 membership.— 534 (3) The State Long-Term Care Ombudsman Council consists of 535 one active certified ombudsman from each local council in eacha536 district and one resident, one family member of a resident, and 537 one consumer advocate, each appointed by the state ombudsman 538plusthree at-large members. 539(a)Each local council in a district must select a540representative of its choice to serve on the state council.541(b)1. The state ombudsman shall submit to the secretary a542list of individuals recommended for appointment to the at-large543positions on the state council. The list may not include the544name of any individual who is currently serving in a district.5452. The secretary shall appoint three at-large members546chosen from the list.547 (4) 548 (c)1. The state council shall elect a chair to serve for a 549 term of 1 year. A chair may not serve more than threetwo550 consecutive terms. 551 2. The chair shall select a vice chair from among the 552 members. The vice chair shall preside over the state council in 553 the absence of the chair. 554 3. The chair may create additional executive positions as 555 necessary to carry out the duties of the state council. Any 556 person appointed to an executive position shall serve at the 557 pleasure of the chair, and his or her term shall expire on the 558 same day as the term of the chair. 559 4. A chair may be immediately removed from office before 560 the expiration of his or her term by a vote of two-thirds of all 561 state council members present at any meeting at which a quorum 562 is present. If a chair is removed from office before the 563 expiration of his or her term, a replacement chair shall be 564 chosen during the same meeting in the same manner as described 565 in this paragraph, and the term of the replacement chair shall 566 begin immediately. The replacement chair shall serve for the 567 remainder of the term and is eligible to serve threetwo568 subsequent consecutive terms. 569 Section 7. Paragraphs (b) and (c) of subsection (1) and 570 paragraph (d) of subsection (2) of section 400.0069, Florida 571 Statutes, are amended to read: 572 400.0069 Long-term care ombudsman districts; local long 573 term care ombudsman councils; duties; appointment.— 574 (1) 575 (b) The state ombudsman shall ensure that there is at least 576 one employee of the department certified as a long-term care 577 ombudsman and a least one local council operating in each 578 district. The state ombudsman may create additional local 579 councils as necessary to ensure that residents throughout the 580 state have meaningfuladequateaccess to State Long-Term Care 581 Ombudsman Program services. 582 (c) Each district shall convene a public meeting at least 583 monthlyquarterly. 584 (2) The duties of the representatives of the State Long 585 Term Care Ombudsman Program are to: 586 (d) Review and, upon an affirmative vote of the state 587 council,if necessary,comment on all existing or proposed 588 rules, regulations, and other governmental policies and actions 589 relating to long-term care facilities whichthatmay potentially 590 have an effect on the health, safety, welfare, and rights of 591 residents. 592 Section 8. Section 400.0073, Florida Statutes, is amended 593 to read: 594 400.0073 State and local ombudsman council investigations.— 595 (1) A representative of the State Long-Term Care Ombudsman 596 Program shall identify and investigate, within a reasonable time 597 after a complaint is made,by or on behalf of a resident 598 relating to actions or omissions by providers or representatives 599 of providers of long-term care services, other public agencies, 600 guardians, or representative payees which may adversely affect 601 the health, safety, welfare, or rights of residents. 602 (2) Subsequent to an appeal from a local council, the state 603 council may investigate any complaint received by the local 604 council involving a long-term care facility or a resident. 605 (3) The state council or a local council may hold a public 606 hearing to assist the State Long-Term Care Ombudsman Program in 607 its investigation of a complaint. 608 (4)(3)If a representative of the State Long-Term Care 609 Ombudsman Program is not allowed to enter a long-term care 610 facility, the administrator of the facility shall be considered 611 to have interfered with a representative of the State Long-Term 612 Care Ombudsman Program in the performance of official duties as 613 described in s. 400.0083(1) and to have violated this part. The 614 representative of the State Long-Term Care Ombudsman Program 615 shall report a facility’s refusal to allow entry to the state 616 ombudsman or his or her designee, who shall report the incident 617 to the agency, and the agency shall record the report and take 618 it into consideration when determining actions allowable under 619 s. 400.102, s. 400.121, s. 429.14, s. 429.19, s. 429.69, or s. 620 429.71. The legal advocate shall pursue legal remedies against a 621 person, a long-term care facility, or another entity that 622 violates s. 400.0083(1). 623 Section 9. Subsections (1), (4), and (5) of section 624 400.0074, Florida Statutes, are amended to read: 625 400.0074 Local ombudsman council onsite administrative 626 assessments.— 627 (1) A representative of the State Long-Term Care Ombudsman 628 Program shall conduct, at least annually, an onsite 629 administrative assessment of each nursing home, assisted living 630 facility, and adult family-care home. This administrative 631 assessment must be comprehensive in nature, must be resident 632 centered, must include a review of the facility’s emergency 633 management plan, and must focus on factors affecting residents’ 634 rights, health, safety, and welfare. Each local council is 635 encouraged to conduct a similar onsite administrative assessment 636 of each newadditionallong-term care facility within its 637 jurisdiction. 638 (4) An onsite administrative assessment may not be 639 accomplished by forcible entry. However, if a representative of 640 the State Long-Term Care Ombudsman Program is not allowed to 641 enter a long-term care facility, the administrator of the 642 facility shall be considered to have interfered with a 643 representative of the State Long-Term Care Ombudsman Program in 644 the performance of official duties as described in s. 645 400.0083(1) and to have committed a violation of this part. The 646 representative of the State Long-Term Care Ombudsman Program 647 shall report the refusal by a facility to allow entry to the 648 state ombudsman or his or her designee, who shall report the 649 incident to the agency, and the agency shall record the report 650 and take it into consideration when determining actions 651 allowable under s. 400.102, s. 400.121, s. 429.14, s. 429.19, s. 652 429.69, or s. 429.71. The legal advocate may pursue legal 653 remedies for any violation of s. 400.0083. 654 (5) The department, in consultation with the state 655 ombudsman, shallmayadopt rules implementing procedures for 656 conducting onsite administrative assessments of long-term care 657 facilities. 658 Section 10. Subsection (3) of section 400.0077, Florida 659 Statutes, is amended to read: 660 400.0077 Confidentiality.— 661 (3) All other matters before the council, including the 662 public discussion of administrative assessments, shall be open 663 to the public and subject to chapter 119 and s. 286.011. 664 Section 11. Subsection (3) is added to section 400.0078, 665 Florida Statutes, and subsections (1) and (2) of that section 666 are republished, to read: 667 400.0078 Citizen access to State Long-Term Care Ombudsman 668 Program services.— 669 (1) The office shall establish a statewide toll-free 670 telephone number and e-mail address for receiving complaints 671 concerning matters adversely affecting the health, safety, 672 welfare, or rights of residents. 673 (2) Upon admission to a long-term care facility, each 674 resident or representative of a resident must receive 675 information regarding: 676 (a) The purpose of the State Long-Term Care Ombudsman 677 Program. 678 (b) The statewide toll-free telephone number and e-mail 679 address for receiving complaints. 680 (c) Information that retaliatory action cannot be taken 681 against a resident for presenting grievances or for exercising 682 any other resident right. 683 (d) Other relevant information regarding how to contact 684 representatives of the State Long-Term Care Ombudsman Program. 685 686 Each resident or his or her representative must be furnished 687 additional copies of this information upon request. 688 (3) The State Long-Term Care Ombudsman Program shall create 689 and make available a poster that includes the statewide toll 690 free telephone number as described in subsection (1) and other 691 relevant contact information for receiving complaints or a 692 summary of residents’ rights. Each long-term care facility shall 693 display a State Long-Term Care Ombudsman Program poster in 694 multiple, conspicuous places. 695 Section 12. Section 400.008, Florida Statutes, is created 696 to read: 697 400.008 Unannounced quality-of-care evaluations.— 698 (1) It is the intent of the Legislature that the 699 environment in long-term care facilities be conducive to the 700 dignity and autonomy of residents and that investigations by the 701 Office of the State Long-Term Care Ombudsman safeguard the 702 health, safety, and welfare of residents. 703 (2) The Office of the State Long-Term Care Ombudsman shall 704 conduct unannounced quality-of-care evaluations of health and 705 long-term care facilities that provide services to the elderly. 706 The office may use undercover personnel to act as patients or 707 employees of the facility. The purpose of the evaluations is to: 708 (a) Identify and track abuse and neglect issues and 709 potential abuse and neglect issues in facilities; 710 (b) Evaluate positive and negative aspects of facility care 711 based on state rules and federal laws and regulations; and 712 (c) Observe facilities’ actions to correct and resolve 713 complaints or allegations of abuse, neglect, or exploitation. 714 (3) Any employee or contractor of the Office of the State 715 Long-Term Care Ombudsman who participates in an evaluation is 716 immune from liability in any civil action related to the 717 evaluation, provided that he or she acted in good faith during 718 the course of the evaluation. 719 Section 13. Section 400.0081, Florida Statutes, is amended 720 to read: 721 400.0081 Access to facilities, residents, and records.— 722 (1) A long-term care facility shall provide representatives 723 of the State Long-Term Care Ombudsman Program with access to: 724 (a) The long-term care facility and its residents. 725 (b) WhenWhereappropriate, medical and social records of a 726 resident for review if: 727 1. The representative of the State Long-Term Care Ombudsman 728 Program has the permission of the resident or the legal 729 representative of the resident; or 730 2. The resident is unable to consent to the review and does 731 not have a legal representative. 732 (c) Medical and social records of a resident as necessary 733 to investigate a complaint, if: 734 1. A legal representative or guardian of the resident 735 refuses to give permission; 736 2. The representative of the State Long-Term Care Ombudsman 737 Program has reasonable cause to believe that the legal 738 representative or guardian is not acting in the best interests 739 of the resident; and 740 3. The representative of the State Long-Term Care Ombudsman 741 Program obtains the approval of the state ombudsman. 742 (d) Administrative records, policies, and documents to 743 which residents or the general public have access. 744 (e) Upon request, copies of all licensing and certification 745 records maintained by the state with respect to a long-term care 746 facility. 747 (2) Copies of records, policies, or documents needed to 748 complete an investigation or assessment must be timely provided 749 by the facility upon request and at no expense to the program. 750 (3)(2)The department, in consultation with the state 751 ombudsman, shallmayadopt rules to establish procedures to 752 ensure access to facilities, residents, and records as described 753 in this section. 754 Section 14. Section 400.0083, Florida Statutes, is amended 755 to read: 756 400.0083 Interference by a person, facility, or entity; 757 retaliation prohibited; criminal penalties; administrative 758 fines; interference by agency.— 759 (1) A person, long-term care facility, or other entity may 760 not willfully interfere with a representative of the State Long 761 Term Care Ombudsman Program in the performance of his or her 762 official duties. 763 (2) A person, long-term care facility, or other entity may 764 not knowingly or willfully take action or retaliate against any 765 resident, employee, or other person for filing a complaint with, 766 providing information to, or otherwise cooperating with any 767 representative of the State Long-Term Care Ombudsman Program. 768 (3) A person, long-term care facility, or other entity that 769 violates this section: 770 (a) Is liable for damages and equitable relief as 771 determined by law. 772 (b) Commits a misdemeanor of the firstseconddegree, 773 punishable as provided in s. 775.083. 774 (4) The Office of the State Long-Term Care Ombudsman shall 775 investigate each alleged violation of subsection (1) or 776 subsection (2) to determine if a violation occurred. If the 777 office determines that a violation occurred, it must report the 778 determination to the agency. The agency shall impose a civil 779 penalty of up to $5,000 per occurrence on a person, long-term 780 care facility, or other entity that the office finds in 781 violation of subsection (1) and a civil penalty of up to $10,000 782 per occurrence on a person, long-term care facility, or other 783 entity that the office finds in violation of subsection (2). The 784 agency shall transfer funds collected pursuant to this 785 subsection into the Quality of Long-Term Care Facility 786 Improvement Trust Fund established under s. 400.0239. The 787 Division of Administrative Hearings shall conduct a hearing if a 788 determination of a violation is contested. The division shall 789 establish by rule procedures for hearing requests. The 790 administrative law judge must render a decision within 90 days 791 after the hearing. 792 (5) The Chief Inspector General shall investigate any 793 willful agency interference with the activities of the State 794 Long-Term Care Ombudsman Program in the performance of its 795 official duties. 796 Section 15. Subsections (1), (3), and (4) of section 797 400.0087, Florida Statutes, are amended to read: 798 400.0087 Department oversight; funding.— 799 (1) The department shall perform its dutiesmeet the costs800 associated with the State Long-Term Care Ombudsman Program from 801 funds appropriated for that purposeto it. 802 (a) The nonprofit organization responsible for the day-to 803 day operations of the program, in consultation with the state 804 ombudsman, shall develop and submit a budget to the department 805 which mustshallinclude the costs associated with 806 administrative support of the State Long-Term Care Ombudsman 807 Programwhen developing its budget requests for consideration by808the Governor and submittal to the Legislature. 809 (b) The department may divert from the federal ombudsman 810 appropriation an amount equal to the department’s administrative 811 cost ratio, which may not exceed 5 percent, to cover the costs 812 associated with administering the State Long-Term Care Ombudsman 813 Program. The remaining allotment from the Older Americans Act 814 program shall be expended on direct ombudsman activities. 815 (3) The department is responsible for ensuring that the 816 State Long-Term Care Ombudsman Program: 817 (a) Has the objectivity and autonomyindependencerequired 818 to qualify it for funding under the federal Older Americans Act. 819 (b) Provides information to public and private agencies, 820 legislators, and others. 821 (c) Provides appropriate training to representatives of the 822 State Long-Term Care Ombudsman Program. 823 (d) Coordinates ombudsman services with Disability Rights 824 Florida, the Advocacy Center for Persons with Disabilities and 825 with providers of legal services to residents of long-term care 826 facilities in compliance with state and federal laws. 827 (4) The department shall also: 828 (a) Receive and disburse state and federal funds for 829 purposes that the state ombudsman has formulated in accordance 830 with the Older Americans Act. 831 (b) Whenever the state ombudsman deems necessary, act as 832 liaison between agencies and branches of the federal and state 833 governments and the State Long-Term Care Ombudsman Program. 834 Section 16. Section 400.0089, Florida Statutes, is amended 835 to read: 836 400.0089 Complaint data reports.— 837 (1) The State Long-Term Care Ombudsman Program shall 838 maintain a statewide uniform reporting system to collect and 839 analyze data relating to complaints and conditions in long-term 840 care facilities and to residents for the purpose of identifying 841 and resolving complaints. 842 (2) Information pertaining to the number and types of 843 complaints received by the State Long-Term Care Ombudsman 844 Program shall be published quarterly and made readily available 845 and shall include all of the following: 846 (a) The license number, name, address, and county of each 847 facility that is the subject of a complaint. 848 (b) The case number and dates that each investigation was 849 opened and closed. 850 (c) The identified complaint codes for each case. 851 (d) The National Ombudsman Reporting System description for 852 each case. 853 (e) The disposition of each case, specified by complaint 854 code. 855 (3) The State Long-Term Care Ombudsman Program shall 856 include an analysis of such information in the annual report 857 required under s. 400.0065. 858 Section 17. Subsection (2) of section 400.0091, Florida 859 Statutes, is amended to read: 860 400.0091 Training.—The state ombudsman shall ensure that 861 appropriate training is provided to all representatives of the 862 State Long-Term Care Ombudsman Program. 863 (2) The state ombudsman shall approve the curriculum for 864 the initial and continuing education training, which must, at a 865 minimum, address: 866 (a) Resident confidentiality. 867 (b) Guardianships and powers of attorney. 868 (c) Medication administration. 869 (d) Care and medication of residents with dementia and 870 Alzheimer’s disease. 871 (e) Accounting for residents’ funds. 872 (f) Discharge rights and responsibilities. 873 (g) Cultural sensitivity. 874 (h) Person-centered care initiatives. 875 (i) Abuse and neglect of residents. 876 (j)(h)Any other topic related to residency in a long-term 877 care facility. 878 Section 18. Section 400.0223, Florida Statutes, is created 879 to read: 880 400.0223 Resident use of electronic monitoring devices in 881 nursing homes.— 882 (1) As used in this section, the term “electronic 883 monitoring device” includes both of the following: 884 (a) Video surveillance cameras installed in the room of a 885 resident. 886 (b) Audio devices installed in the room of a resident 887 designed to acquire communications or other sounds occurring in 888 the room. 889 (2) A nursing home shall allow a resident; the resident’s 890 surrogate; the resident’s guardian; or, at the resident’s 891 request, the resident’s personal representative to monitor the 892 resident’s room through the use of electronic monitoring 893 devices. 894 (3) The nursing home shall require the person who conducts 895 electronic monitoring to post a notice on the door to the 896 resident’s room stating that the room is being monitored by an 897 electronic monitoring device. 898 (4) Electronic monitoring conducted under this section is 899 voluntary and may be conducted only at the request and expense 900 of the resident, the resident’s surrogate, the resident’s 901 guardian, or the resident’s personal representative. To the 902 extent possible, such monitoring must protect the privacy rights 903 of other residents and visitors to the nursing home. 904 (5)(a) A nursing home may not inquire of a prospective 905 resident or the representative of a prospective resident who is 906 applying to reside at the facility regarding the resident’s 907 intentions to use an electronic monitoring device and may not 908 refuse an application for residency or remove a resident from 909 the nursing home on the basis of intent to use or use of an 910 electronic monitoring device. 911 (b) A nursing home shall inform a resident, the resident’s 912 surrogate, the resident’s guardian, or the personal 913 representative of the resident of the resident’s right to 914 conduct electronic monitoring. 915 (6) A nursing home shall make reasonable physical 916 accommodations to facilitate electronic monitoring and shall 917 provide a reasonably secure place to mount an electronic 918 monitoring device and access to a power source for the device. 919 (7) If electronic monitoring is conducted by or on behalf 920 of a resident, the nursing home may require the resident, the 921 resident’s surrogate, the resident’s guardian, or the resident’s 922 personal representative to conduct the electronic monitoring in 923 plain view. 924 (8) A nursing home may require that a request to conduct 925 electronic monitoring be made in writing. 926 (9) Subject to applicable rules of evidence and procedure, 927 an audio or video recording created through the use of 928 electronic monitoring conducted under this section may be 929 admitted into evidence in any court or administrative 930 proceeding. 931 (10) An administrator of a nursing home who knowingly 932 refuses to allow a resident; the resident’s surrogate; the 933 resident’s guardian; or, at the request of the resident, the 934 resident’s personal representative to monitor the room of the 935 resident in accordance with this section through the use of an 936 electronic monitoring device commits a misdemeanor of the second 937 degree, punishable under s. 775.082 or s. 775.083. 938 (11) An administrator of a nursing home who knowingly 939 refuses to admit a person to residency or knowingly allows the 940 removal of a resident from the nursing home because of a request 941 to conduct electronic monitoring under this section commits a 942 misdemeanor of the second degree, punishable under s. 775.082 or 943 s. 775.083. 944 (12)(a) An employee, officer, or other agent of a nursing 945 home may not intentionally hamper, obstruct, tamper with, or 946 destroy an electronic monitoring device installed in a 947 resident’s room in accordance with this section, or a tape or 948 recording made by such a device, unless he or she first obtains 949 the written consent of the resident, the resident’s surrogate, 950 the resident’s guardian, or the resident’s personal 951 representative on a form provided by the agency. Such consent 952 form must be signed by the resident or the person representing 953 the resident who made the request and one other witness. 954 (b) In the absence of such written consent, an employee, 955 officer, or other agent of a nursing home who intentionally 956 hampers, obstructs, tampers with, or destroys an electronic 957 monitoring device installed in a resident’s room in accordance 958 with this section, or a tape or recording made by such a device, 959 commits a misdemeanor of the first degree, punishable under s. 960 775.082 or s. 775.083. 961 (13) The agency shall impose a civil penalty not to exceed 962 $500 per violation per day on a licensee who operates a nursing 963 home found to be in violation of this section. The agency shall 964 transfer funds collected pursuant to this subsection into the 965 Quality of Long-Term Care Facility Improvement Trust Fund 966 established under s. 400.0239. 967 Section 19. Section 400.0238, Florida Statutes, is 968 repealed. 969 Section 20. Subsection (1) of section 400.0239, Florida 970 Statutes, is amended to read: 971 400.0239 Quality of Long-Term Care Facility Improvement 972 Trust Fund.— 973 (1) There is created within the Agency for Health Care 974 Administration a Quality of Long-Term Care Facility Improvement 975 Trust Fund to support activities and programs directly related 976 to improvement of the care of nursing home and assisted living 977 facility residents. The trust fund shall be funded through 978 proceeds generated pursuant to ss. 400.0083 and 400.0223ss.979400.0238 and 429.298, through funds specifically appropriated by 980 the Legislature, through gifts, endowments, and other charitable 981 contributions allowed under federal and state law, and through 982 federal nursing home civil monetary penalties collected by the 983 Centers for Medicare and Medicaid Services and returned to the 984 state. These funds must be utilized in accordance with federal 985 requirements. 986 Section 21. Section 400.1185, Florida Statutes, is created 987 to read: 988 400.1185 Internal resident safety and quality-of-care 989 coordinator program.— 990 (1) Each licensed facility shall establish an internal 991 resident safety and quality-of-care coordinator program that 992 includes all of the following: 993 (a) An analysis of the frequency and causes of violations 994 of residents’ rights and of adverse incidents. 995 (b) An analysis of resident and family member grievances 996 that relate to resident safety and quality of care. 997 (c) The development and implementation of measures to 998 promote autonomy within the facility, to enhance the quality of 999 life and the safety of residents, and to decrease the frequency 1000 of violations of residents’ rights and of adverse incidents. 1001 (d) Safety and risk prevention education and the training 1002 of all nonphysician personnel who provide resident care, which 1003 must be included as part of the initial orientation of such 1004 personnel. Such personnel must complete at least 5 additional 1005 hours of education and training annually. 1006 (e) The development and implementation of a reporting 1007 system that requires all employees and agents of the licensed 1008 facility to report adverse incidents to the quality-of-care 1009 coordinator, as described in subsection (2), or to his or her 1010 designee, within 3 business days after the adverse incident 1011 occurs. 1012 (2) The internal resident safety and quality-of-care 1013 coordinator programs are the responsibility of the governing 1014 board of each facility. Each facility shall hire a risk manager 1015 who shall act as the quality-of-care coordinator and be 1016 responsible for implementation and oversight of the facility’s 1017 internal resident safety and quality-of-care coordinator 1018 program. The risk manager may not be made responsible for 1019 internal resident safety and quality-of-care coordinator 1020 programs in more than four facilities licensed under this 1021 chapter. 1022 (3) In addition to the programs created under this section, 1023 the development of other innovative approaches is encouraged to 1024 reduce the frequency and severity of adverse incidents and of 1025 violations of residents’ rights. 1026 (4) The agency shall adopt rules to administer the internal 1027 resident safety and quality-of-care coordinator programs. Each 1028 program must file any collected incident reports with an 1029 employee designated by the facility, who must be proficient in 1030 resident safety techniques and must have access to all resident 1031 care and safety records of the facility, including internal and 1032 state-required incident reports. An individual who files an 1033 incident report is not subject to civil suit by virtue of filing 1034 the incident report. For purposes of this section, the term 1035 “adverse incident” means a situation that facility personnel 1036 were in control of and that appropriate safety measures could 1037 have prevented which results in any of the following to a 1038 resident: 1039 (a) Death. 1040 (b) Brain or spinal damage. 1041 (c) Permanent disfigurement. 1042 (d) A fracture or dislocation of bones or joints. 1043 (e) A limitation of neurological, physical, or sensory 1044 function. 1045 (f) Sexual abuse. 1046 (g) Assault or battery. 1047 (h) Any condition that requires the transfer of a resident 1048 to a unit, within or outside of the facility, to provide a more 1049 acute level of care. 1050 (5)(a) By January 31 of each year, each licensed facility 1051 shall submit a report to the agency summarizing incident reports 1052 filed during the previous calendar year. The report must 1053 include: 1054 1. The total number of adverse incidents. 1055 2. A listing, by category, of the causes of each injury or 1056 death and the number of incidents occurring within each 1057 category. 1058 3. A code number using the facility staff’s licensure 1059 number and a separate code number identifying all other 1060 individuals directly involved in adverse incidents of residents, 1061 the relationship of the individual to the licensed facility, and 1062 the number of incidents in which each individual has been 1063 directly involved. Each licensed facility shall maintain names 1064 of the health care professionals and individuals identified by 1065 code numbers for purposes of this section. 1066 4. A description of all claims filed against the licensed 1067 facility for a violation of a resident’s rights, as specified in 1068 s. 400.022, including the total number of pending and closed 1069 claims, the names of the individuals involved in each claim, the 1070 nature of the incident that led to each claim, and the status 1071 and disposition of each claim. Each report must provide an 1072 updated status for any claims identified as being unresolved or 1073 pending in the prior year report. 1074 5. The number and nature of disciplinary actions taken 1075 against agents or employees of the facility related to patient 1076 care and safety. 1077 (b) The agency shall review the information submitted 1078 pursuant to paragraph (a) and determine if any reported 1079 incidents may subject a facility or an employee or agent of a 1080 facility to disciplinary action. 1081 (c) The report submitted to the agency must also provide 1082 the name and license number of the quality-of-care coordinator 1083 of the licensed facility, a copy of the facility’s policies and 1084 procedures that govern the actions taken by the facility and its 1085 quality-of-care coordinator to reduce the risk of injuries and 1086 deaths and violations of residents’ rights, and the results of 1087 actions taken by the facility. 1088 (6)(a) A licensed facility shall submit an adverse incident 1089 report to the agency no later than 1 business day after the 1090 quality-of-care coordinator or his or her designee has received 1091 the report through the system implemented pursuant to paragraph 1092 (1)(e). The report may be submitted to the agency through e 1093 mail, facsimile, or overnight mail delivery. The facility must 1094 submit the following information with the report: 1095 1. The identity of the affected resident; 1096 2. The type of adverse incident; 1097 3. Information on any investigation into the incident 1098 conducted by the facility; and 1099 4. An assessment as to whether the events causing or 1100 resulting in the adverse incident represent a potential risk to 1101 other residents. 1102 (b) After receiving the report, the agency must determine 1103 by the end of the next business day if any of the following 1104 adverse incidents has occurred, whether arising from events that 1105 occurred in the licensed facility or from events that occurred 1106 before the resident’s admission into the licensed facility: 1107 1. The death of a resident; 1108 2. Brain or spinal damage to a resident; 1109 3. Sexual abuse of a resident; or 1110 4. The assault or battery of a resident. 1111 (7) The agency shall require a written plan of correction 1112 from a facility that violates this section. For a single 1113 incident or a series of isolated incidents that are nonwillful 1114 violations of the reporting requirements of this section, the 1115 agency shall first demand that the facility take corrective 1116 action. If the facility does not demonstrate completion of the 1117 corrective action within the timeframe allowed by the agency or 1118 demonstrates a pattern of nonwillful violations of this section, 1119 the agency may impose a civil penalty not to exceed $5,000 for 1120 each violation of the reporting requirements of this section. 1121 The civil penalty for repeated nonwillful violations may not 1122 exceed $10,000 for each violation. The administrative fine for 1123 each intentional and willful violation may not exceed $25,000 1124 per violation per day. 1125 (8) The agency must be given access to facility records 1126 needed in the administration of this section. 1127 (9) The agency shall review, as part of its licensure 1128 inspection process, the internal resident safety and quality-of 1129 care coordinator program at each licensed facility subject to 1130 this section to determine whether it complies with this section, 1131 is being conducted in a manner designed to reduce adverse 1132 incidents and violations of residents’ rights, and is 1133 appropriately reporting incidents under subsections (4) through 1134 (6). 1135 (10) There shall be no monetary liability on the part of, 1136 and no cause of action for damages shall arise against, any 1137 quality-of-care coordinator for the implementation and oversight 1138 of an internal resident safety and quality-of-care coordinator 1139 program for any act or proceeding undertaken or performed within 1140 the scope of the functions of the program so long as the 1141 quality-of-care coordinator acts without intentional fraud. 1142 (11) If the agency, through its receipt of the annual 1143 reports required in subsection (5) or through any investigation, 1144 has a reasonable belief that the conduct of an agent or employee 1145 of a licensed facility constitutes grounds for disciplinary 1146 action by the appropriate regulatory board, the agency must 1147 report its findings to that board. 1148 (12) Beginning on July 1, 2019, and by each July 1 1149 thereafter, the agency shall publish on its website a report 1150 card summarizing the information contained in the annual reports 1151 submitted by licensed facilities pursuant to subsection (5) and 1152 disciplinary actions reported to the agency. The report card 1153 must be organized by county and, for each licensed facility in 1154 the state, must include an itemized list that provides the 1155 following information: 1156 (a) The name and address of the facility. 1157 (b) If the facility is structured as a private for-profit, 1158 not-for-profit, or public company. 1159 (c) The total number of beds in the facility. 1160 (d) A description of the categories of services provided by 1161 the facility. 1162 (e) The percentage of adverse incidents per total number of 1163 residents in the facility, by category of reported incident. 1164 (f) The number of claims filed for violations of the 1165 resident’s rights under s. 400.022, by category of violation. 1166 (g) A listing, by category, of the actions or inactions 1167 giving rise to the adverse incidents and claims filed for a 1168 violation of a resident’s rights and the number in each 1169 category. 1170 (h) The number of and descriptions of disciplinary actions 1171 taken against a facility or agents or employees of that 1172 facility. 1173 (i) The following statement: 1174 1175 “This report card is just one measure of the quality 1176 of a facility. You may want to obtain and consider 1177 other information to determine whether this facility 1178 is right for you or your loved ones. This report card 1179 is not adjusted to reflect the size of the facility or 1180 the severity or complexity of the custodial and health 1181 care needs of the residents it serves, and, therefore, 1182 some facilities may appear to have more frequent 1183 adverse incidents and claims involving violations of 1184 residents’ rights than others.” 1185 1186 The first report card issued pursuant to this subsection may be 1187 based on a partial year of data, if necessary. 1188 Section 22. Paragraph (q) of subsection (1) of section 1189 400.141, Florida Statutes, is amended to read: 1190 400.141 Administration and management of nursing home 1191 facilities.— 1192 (1) Every licensed facility shall comply with all 1193 applicable standards and rules of the agency and shall: 1194 (q) Satisfy the financial requirements in s. 400.1411, 1195 which may not be used for litigation costs or attorney fees for 1196 the defense of any claim against a nursing home facility 1197 pursuant to common law or s. 400.023 or s. 400.0233Maintain1198general and professional liability insurance coverage that is in1199force at all times. In lieu of satisfying the financial 1200 requirements in s. 400.1411such coverage, a state-designated 1201 teaching nursing home and its affiliated assisted living 1202 facilities created under s. 430.80 may demonstrate proof of 1203 financial responsibility as provided in s. 430.80(3)(g). 1204 Section 23. Section 400.1411, Florida Statutes, is created 1205 to read: 1206 400.1411 Financial requirements.— 1207 (1) As a condition of licensure, a nursing home facility 1208 must at all times demonstrate to the satisfaction of the agency 1209 and the Office of Insurance Regulation of the Financial Services 1210 Commission the financial ability to pay claims, and costs 1211 ancillary thereto, arising out of the rendering of, or the 1212 failure to render, care or services, by doing one of the 1213 following: 1214 (a) Establishing and maintaining an escrow account 1215 consisting of cash or assets eligible for deposit in accordance 1216 with s. 625.52 in the per-claim amounts specified in paragraph 1217 (b). 1218 (b) Obtaining and maintaining general and professional 1219 liability coverage in an amount not less than $1 million per 1220 claim, with a minimum annual aggregate of not less than $3 1221 million, from an authorized insurer as defined in s. 624.09, 1222 from an eligible surplus lines insurer as defined in s. 1223 626.914(2), or from a Florida-domiciled risk retention group as 1224 defined in s. 627.942(9). 1225 (c) Obtaining and maintaining an unexpired, irrevocable 1226 letter of credit, established pursuant to chapter 675, in an 1227 amount not less than $1 million per claim, with a minimum 1228 aggregate availability of credit not less than $3 million. The 1229 letter of credit must be payable to the nursing home facility as 1230 beneficiary upon presentment of a final judgment indicating 1231 liability and awarding damages to be paid by the nursing home 1232 facility or upon presentment of a settlement agreement signed by 1233 all parties to such agreement when such final judgment or 1234 settlement is a result of a claim arising out of the rendering 1235 of, or the failure to render, care and services. The letter of 1236 credit must be nonassignable and nontransferable. The letter of 1237 credit must be issued by a bank or savings association organized 1238 and existing under the laws of this state or under the laws of 1239 the United States which has its principal place of business in 1240 this state or has a branch office authorized under the laws of 1241 this state or of the United States to receive deposits in this 1242 state. 1243 (2) Each insurer, self-insurer, or risk retention group 1244 must promptly notify the agency and the office of cancellation 1245 or nonrenewal of insurance required by this section. 1246 (3) Upon the entry by a Florida court of an adverse final 1247 judgment against a licensee as defined in s. 400.023(2) which 1248 arises from an award pursuant to s. 400.023, including an 1249 arbitration award, for a claim of negligence or a violation of 1250 residents’ rights, in contract or tort, or from noncompliance 1251 with the terms of a settlement agreement as determined by a 1252 court or arbitration panel which arises from a claim pursuant to 1253 s. 400.023, the licensee shall pay the plaintiff the entire 1254 amount of the judgment, award, or settlement and all accrued 1255 interest pursuant to s. 400.024. 1256 (4) Any deceptive, untrue, or fraudulent representation or 1257 violation of this section by any individual or entity on behalf 1258 of the facility may result in disciplinary action pursuant to s. 1259 400.121 with no aggregate limit. If a nursing home shows a 1260 continuous pattern of violation of this section, the agency must 1261 issue a conditional license and may immediately suspend the 1262 license. 1263 Section 24. Subsection (3) of section 400.19, Florida 1264 Statutes, is amended to read: 1265 400.19 Right of entry and inspection.— 1266 (3) Every 15 months, the agency shallevery 15 months1267 conduct at least one unannounced inspection to determine 1268 compliance by the licensee with the laws of this state and 1269 administrative rules that governstatutes, and with rules1270promulgated underthe provisions ofthose statutes, governing1271 minimum standards of construction, electricity, and emergency 1272 power sources; quality and adequacy of care;,and rights of 1273 residents.The survey shall be conducted every 6 months for the1274next 2-year periodIf athefacility has been cited for a class 1275 I deficiency or, has been citedfor two or more class II 1276 deficiencies arising from separate surveys or investigations 1277 within a 60-day period,or has had three or more substantiated 1278 complaints within a 6-month period, each resulting in at least 1279 one class I or class II deficiency, the agency shall conduct 1280 unannounced inspections at 6-month intervals over the course of 1281 the next 2-year period. In addition to any other fees or fines 1282 in this part, the agency shall assess a fine for each facility 1283 that is subject to the 6-month survey cycle. The fine for the 2 1284 year period isshall be$6,000, one-half to be paid at the 1285 completion of each survey. The agency may adjust this fine by 1286 the change in the Consumer Price Index, based on the 12 months 1287 immediately preceding the increase, to cover the cost of the 1288 additional surveys. The agency shall verify through subsequent 1289 inspection that any deficiency identified during inspection is 1290 corrected. However, the agency may verify the correction of a 1291 class III or class IV deficiency unrelated to resident rights or 1292 resident care without reinspecting the facility if adequate 1293 written documentation has been received from the facility,which 1294 provides assurance that the deficiency has been corrected. The 1295 giving or causing to be given of advance notice of such 1296 unannounced inspections by an employee of the agency to any 1297 unauthorized person constitutes groundsshall constitute cause1298 for the suspension of such person, pursuant to chapter 110, for 1299 not fewer than 5 working daysaccording to the provisions of1300chapter 110. 1301 Section 25. Subsection (3) of section 400.191, Florida 1302 Statutes, is amended to read: 1303 400.191 Availability, distribution, and posting of reports 1304 and records.— 1305 (3) Each nursing home facility licensee shall maintain as 1306 public information, available upon request, records of all cost 1307 and inspection reports pertaining to that facility whichthat1308 have been filed with, or issued by, any governmental agency. 1309 Copies of the reports shall be retained in the records for not 1310 less than 5 years following the date the reports are filed or 1311 issued. 1312 (a) The agency shall publish in the Nursing Home Guide a 1313 “Nursing Home Guide Watch List” to assist consumers in 1314 evaluating the quality of nursing home care in Florida. The 1315 watch list must identify each facility that met the criteria for 1316 a conditional licensure status and each facility that is 1317 operating under bankruptcy protection. The watch list must 1318 include, but needisnot be limited to, the facility’s name, 1319 address, and ownership; the county in which the facility 1320 operates; the license expiration date; the number of licensed 1321 beds; a description of the deficiency causing the facility to be 1322 placed on the list; any corrective action taken; and the 1323 cumulative number of days and percentage of days the facility 1324 had a conditional license in the past 30 months. The watch list 1325 must include a brief description regarding how to choose a 1326 nursing home, the categories of licensure, the agency’s 1327 inspection process, an explanation of terms used in the watch 1328 list, and the addresses and phone numbers of the agency’s health 1329 quality assurance field offices. 1330 (b) Upon publication of each Nursing Home Guide, the agency 1331 shallmustpost a copy of the guide on its website by the 15th 1332 calendar day of the second month following the end of the 1333 calendar quarter. Each nursing home licensee must retrieve the 1334 most recent version of the Nursing Home Guide from the agency’s 1335 website. 1336 (c)1. A facility on the watch list must conspicuously post 1337 a sign on each entrance to the facility. The lettering must be 1338 red, in at least 48-point type, and printed on white card stock. 1339 The sign must read as follows: 1340 1341 “NOTICE: THIS FACILITY IS ON FLORIDA’S NURSING HOME GUIDE WATCH 1342 LIST.” 1343 1344 2. Signs must remain posted for the duration of the 30 1345 month watch list period. If the agency determines that a 1346 facility is in violation of this section, the agency must cite 1347 the facility for a class I violation, place the facility on a 6 1348 month inspection cycle, and extend the duration of the 1349 facility’s inclusion on the watch list for an additional 30 1350 months. 1351 Section 26. Section 400.226, Florida Statutes, is created 1352 to read: 1353 400.226 Mandatory compliance with federal requirements. 1354 Licensed nursing homes shall comply with the requirements of 42 1355 C.F.R. 483, which are incorporated herein by reference. A 1356 violation of the residents’ rights established under this 1357 section is considered negligence per se. 1358 Section 27. Paragraphs (d) and (g) of subsection (2) and 1359 paragraph (a) of subsection (8) of section 400.23, Florida 1360 Statutes, are amended to read: 1361 400.23 Rules; evaluation and deficiencies; licensure 1362 status.— 1363 (2) Pursuant to the intention of the Legislature, the 1364 agency, in consultation with the Department of Health and the 1365 Department of Elderly Affairs, shall adopt and enforce rules to 1366 implement this part and part II of chapter 408, which shall 1367 include reasonable and fair criteria in relation to: 1368 (d) The equipment essential to the health and welfare of 1369 the residents, including equipment sufficient to provide 1370 adequate day-to-day electricity, a fully operational emergency 1371 power source, and a supply of fuel sufficient to sustain the 1372 emergency power source for at least 96 hours during a power 1373 outage. The emergency power source must provide enough 1374 electricity to consistently maintain an air temperature between 1375 71° and 81° F in the facility. 1376 (g) The preparation and annual update of a comprehensive 1377 emergency management plan. The agency shall adopt rules 1378 establishing minimum criteria for the plan after consultation 1379 with the Division of Emergency Management. At a minimum, the 1380 rules must provide for plan components that address emergency 1381 evacuation transportation; adequate sheltering arrangements; 1382 postdisaster activities, including emergency power, food, and 1383 water; postdisaster transportation; supplies; staffing; 1384 emergency equipment; individual identification of residents and 1385 transfer of records; and responding to family inquiries. The 1386 plan must provide for the evacuation of all residents in the 1387 event that the facility experiences a power outage and is unable 1388 to sustain adequate emergency power as required in paragraph 1389 (d). The comprehensive emergency management plan is subject to 1390 review and approval by the local emergency management agency. 1391 During its review, the local emergency management agency shall 1392 ensure that the following agencies, at a minimum, are given the 1393 opportunity to review the plan: the Department of Elderly 1394 Affairs, the Department of Health, the Agency for Health Care 1395 Administration, and the Division of Emergency Management. Also, 1396 appropriate volunteer organizations must be given the 1397 opportunity to review the plan. The local emergency management 1398 agency shall complete its review within 60 days and either 1399 approve the plan or advise the facility of necessary revisions. 1400 (8) The agency shall adopt rules pursuant to this part and 1401 part II of chapter 408 to provide that, when the criteria 1402 established under subsection (2) are not met, such deficiencies 1403 shall be classified according to the nature and the scope of the 1404 deficiency. The scope shall be cited as isolated, patterned, or 1405 widespread. An isolated deficiency is a deficiency affecting one 1406 or a very limited number of residents, or involving one or a 1407 very limited number of staff, or a situation that occurred only 1408 occasionally or in a very limited number of locations. A 1409 patterned deficiency is a deficiency where more than a very 1410 limited number of residents are affected, or more than a very 1411 limited number of staff are involved, or the situation has 1412 occurred in several locations, or the same resident or residents 1413 have been affected by repeated occurrences of the same deficient 1414 practice but the effect of the deficient practice is not found 1415 to be pervasive throughout the facility. A widespread deficiency 1416 is a deficiency in which the problems causing the deficiency are 1417 pervasive in the facility or represent systemic failure that has 1418 affected or has the potential to affect a large portion of the 1419 facility’s residents. The agency shall indicate the 1420 classification on the face of the notice of deficiencies as 1421 follows: 1422 (a) A class I deficiency is a deficiency that the agency 1423 determines presents a situation in which immediate corrective 1424 action is necessary because the facility’s noncompliance has 1425 caused, or is likely to cause, serious injury, harm, impairment, 1426 or death to a resident receiving care in a facility. The 1427 condition or practice constituting a class I violation shall be 1428 abated or eliminated immediately, unless a fixed period of time, 1429 as determined by the agency, is required for correction. A class 1430 I deficiency is subject to a civil penalty of $10,000 for an 1431 isolated deficiency, $12,500 for a patterned deficiency, and 1432 $15,000 for a widespread deficiency. If the agency determines 1433 that a resident died as the result of abuse or neglect, it shall 1434 immediately impose a $1 million civil penalty on the facility 1435 for the deficiency. The fine amount shall be doubled for each 1436 deficiency if the facility was previously cited for one or more 1437 class I or class II deficiencies during the last licensure 1438 inspection or any inspection or complaint investigation since 1439 the last licensure inspection. A fine must be levied 1440 notwithstanding the correction of the deficiency. 1441 Section 28. Paragraph (a) of subsection (1) of section 1442 406.11, Florida Statutes, is amended to read: 1443 406.11 Examinations, investigations, and autopsies.— 1444 (1) In any of the following circumstances involving the 1445 death of a human being, the medical examiner of the district in 1446 which the death occurred or the body was found shall determine 1447 the cause of death and shall, for that purpose, make or have 1448 performed such examinations, investigations, and autopsies as he 1449 or she shall deem necessary or as shall be requested by the 1450 state attorney: 1451 (a) When any person dies in the state: 1452 1. Of criminal violence. 1453 2. By accident. 1454 3. By suicide. 1455 4. Suddenly, when in apparent good health. 1456 5. Unattended by a practicing physician or other recognized 1457 practitioner. 1458 6. In any prison or penal institution. 1459 7. In any nursing home on the federal Special Focus 1460 Facility list or on the Nursing Home Guide Watch List as 1461 described in s. 400.191(3)(a). 1462 8.7.In police custody. 1463 9.8.In any suspicious or unusual circumstance. 1464 10.9.By criminal abortion. 1465 11.10.By poison. 1466 12.11.By disease constituting a threat to public health. 1467 13.12.By disease, injury, or toxic agent resulting from 1468 employment. 1469 Section 29. Section 406.13, Florida Statutes, is amended to 1470 read: 1471 406.13 Examiner’s report; maintenance of records.—Upon 1472 receipt of such notification pursuant to s. 406.12, the district 1473 medical examiner or her or his associate shall examine or 1474 otherwise take charge of the dead body and shall notify the 1475 appropriate law enforcement agency pursuant to s. 406.145. When 1476 the cause of death has been established within reasonable 1477 medical certainty by the district medical examiner or her or his 1478 associate, she or he shall so report or make available to the 1479 state attorney, in writing, her or his determination as to the 1480 cause of said death. If it is determined that a nursing home 1481 resident died as the result of abuse, sexual abuse, or 1482 negligence, the medical examiner must notify and forward all 1483 documentation in support of the determination to the state 1484 attorney. Upon receipt of such notification, the state attorney 1485 shall seat a grand jury within 90 days and investigate whether 1486 the filing of criminal charges is warranted. Duplicate copies of 1487 records and the detailed findings of autopsy and laboratory 1488 investigations shall be maintained by the district medical 1489 examiner. Any evidence or specimen coming into the possession of 1490 said medical examiner in connection with any investigation or 1491 autopsy may be retained by the medical examiner or be delivered 1492 to one of the law enforcement officers assigned to the 1493 investigation of the death. 1494 Section 30. Section 429.298, Florida Statutes, is repealed. 1495 Section 31. Subsection (2) of section 429.34, Florida 1496 Statutes, is amended to read: 1497 429.34 Right of entry and inspection.— 1498 (2) The agency shall inspect each licensed assisted living 1499 facility at least once every 24 months to determine compliance 1500 by the licensee with this chapter and related rules governing 1501 minimum standards of construction, electricity, and emergency 1502 power sources; quality and adequacy of care; and resident 1503 rights. If an assisted living facility is cited for a class I 1504 violation or three or more class II violations arising from 1505 separate surveys within a 60-day period or due to unrelated 1506 circumstances during the same survey, the agency must conduct an 1507 additional licensure inspection within 6 months. 1508 Section 32. Paragraphs (a) and (b) of subsection (1) of 1509 section 429.41, Florida Statutes, are amended to read: 1510 429.41 Rules establishing standards.— 1511 (1) It is the intent of the Legislature that rules 1512 published and enforced pursuant to this section shall include 1513 criteria by which a reasonable and consistent quality of 1514 resident care and quality of life may be ensured and the results 1515 of such resident care may be demonstrated. Such rules shall also 1516 ensure a safe and sanitary environment that is residential and 1517 noninstitutional in design or nature. It is further intended 1518 that reasonable efforts be made to accommodate the needs and 1519 preferences of residents to enhance the quality of life in a 1520 facility. Uniform firesafety standards for assisted living 1521 facilities shall be established by the State Fire Marshal 1522 pursuant to s. 633.206. The agency, in consultation with the 1523 department, may adopt rules to administer the requirements of 1524 part II of chapter 408. In order to provide safe and sanitary 1525 facilities and the highest quality of resident care 1526 accommodating the needs and preferences of residents, the 1527 department, in consultation with the agency, the Department of 1528 Children and Families, and the Department of Health, shall adopt 1529 rules, policies, and procedures to administer this part, which 1530 must include reasonable and fair minimum standards in relation 1531 to: 1532 (a) The requirements for and maintenance of facilities, not 1533 in conflict with chapter 553, relating to electricity, plumbing, 1534 heating, cooling, lighting, ventilation, living space, and other 1535 housing conditions, which will ensure the health, safety, and 1536 comfort of residents suitable to the size of the structure. 1537 1. Firesafety evacuation capability determination.—An 1538 evacuation capability evaluation for initial licensure shall be 1539 conducted within 6 months after the date of licensure. 1540 2. Firesafety requirements.— 1541 a. The National Fire Protection Association, Life Safety 1542 Code, NFPA 101 and 101A, current editions, shall be used in 1543 determining the uniform firesafety code adopted by the State 1544 Fire Marshal for assisted living facilities, pursuant to s. 1545 633.206. 1546 b. A local government or a utility may charge fees only in 1547 an amount not to exceed the actual expenses incurred by the 1548 local government or the utility relating to the installation and 1549 maintenance of an automatic fire sprinkler system in a licensed 1550 assisted living facility structure. 1551 c. All licensed facilities must have an annual fire 1552 inspection conducted by the local fire marshal or authority 1553 having jurisdiction. 1554 d. An assisted living facility that is issued a building 1555 permit or certificate of occupancy before July 1, 2016, may at 1556 its option and after notifying the authority having 1557 jurisdiction, remain under the provisions of the 1994 and 1995 1558 editions of the National Fire Protection Association, Life 1559 Safety Code, NFPA 101, and NFPA 101A. The facility opting to 1560 remain under such provisions may make repairs, modernizations, 1561 renovations, or additions to, or rehabilitate, the facility in 1562 compliance with NFPA 101, 1994 edition, and may utilize the 1563 alternative approaches to life safety in compliance with NFPA 1564 101A, 1995 edition. However, a facility for which a building 1565 permit or certificate of occupancy is issued before July 1, 1566 2016, that undergoes Level III building alteration or 1567 rehabilitation, as defined in the Florida Building Code, or 1568 seeks to utilize features not authorized under the 1994 or 1995 1569 editions of the Life Safety Code must thereafter comply with all 1570 aspects of the uniform firesafety standards established under s. 1571 633.206, and the Florida Fire Prevention Code, in effect for 1572 assisted living facilities as adopted by the State Fire Marshal. 1573 3. Resident elopement requirements.—Facilities are required 1574 to conduct a minimum of two resident elopement prevention and 1575 response drills per year. All administrators and direct care 1576 staff must participate in the drills which shall include a 1577 review of procedures to address resident elopement. Facilities 1578 must document the implementation of the drills and ensure that 1579 the drills are conducted in a manner consistent with the 1580 facility’s resident elopement policies and procedures. 1581 4. Emergency power sources for use during power outages. 1582 Facilities are required to maintain a fully operational 1583 emergency power source and a supply of fuel sufficient to 1584 sustain the emergency power source for at least 96 hours during 1585 a power outage. The emergency power source must provide enough 1586 electricity to consistently maintain an air temperature between 1587 71° and 81° F in the facility. 1588 (b) The preparation and annual update of a comprehensive 1589 emergency management plan. Such standards must be included in 1590 the rules adopted by the department after consultation with the 1591 Division of Emergency Management. At a minimum, the rules must 1592 provide for plan components that address emergency evacuation 1593 transportation; adequate sheltering arrangements; postdisaster 1594 activities, including provision of emergency power, food, and 1595 water; postdisaster transportation; supplies; staffing; 1596 emergency equipment; individual identification of residents and 1597 transfer of records; communication with families; and responses 1598 to family inquiries. The comprehensive emergency management plan 1599 must provide for the evacuation of all residents of a facility 1600 if the facility experiences a power outage and is unable to 1601 sustain emergency power, as required in subparagraph (a)4. The 1602 comprehensive emergency management plan is subject to review and 1603 approval by the local emergency management agency. During its 1604 review, the local emergency management agency shall ensure that 1605 the following agencies, at a minimum, are given the opportunity 1606 to review the plan: the Department of Elderly Affairs, the 1607 Department of Health, the Agency for Health Care Administration, 1608 and the Division of Emergency Management. Also, appropriate 1609 volunteer organizations must be given the opportunity to review 1610 the plan. The local emergency management agency shall complete 1611 its review within 60 days and either approve the plan or advise 1612 the facility of necessary revisions. 1613 Section 33. This act shall take effect July 1, 2018.