Bill Text: FL S0268 | 2014 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Certificates of Need
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2014-04-23 - Laid on Table, companion bill(s) passed, see CS/CS/HB 287 (Ch. 2014-110) [S0268 Detail]
Download: Florida-2014-S0268-Introduced.html
Bill Title: Certificates of Need
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2014-04-23 - Laid on Table, companion bill(s) passed, see CS/CS/HB 287 (Ch. 2014-110) [S0268 Detail]
Download: Florida-2014-S0268-Introduced.html
Florida Senate - 2014 SB 268 By Senator Grimsley 21-00284A-14 2014268__ 1 A bill to be entitled 2 An act relating to certificates of need; amending s. 3 408.034, F.S.; decreasing the subdistrict average 4 occupancy rate that the Agency for Health Care 5 Administration is required to maintain as a goal of 6 its nursing-home-bed-need methodology; conforming a 7 provision to changes made by the act; authorizing an 8 applicant to aggregate the need of geographically 9 contiguous subdistricts within a district for a 10 proposed community nursing home under certain 11 circumstances; requiring the proposed nursing home 12 site to be located in the subdistrict with the greater 13 need under certain circumstances; amending s. 408.036, 14 F.S.; providing that, under certain circumstances, 15 replacement of a nursing home is a health-care-related 16 project subject to expedited review; conforming a 17 cross-reference; revising the requirements for 18 projects that are exempted from applying for a 19 certificate of need; repealing s. 408.0435, F.S., 20 relating to the moratorium on the approval of 21 certificates of need for additional community nursing 22 home beds; providing an effective date. 23 24 Be It Enacted by the Legislature of the State of Florida: 25 26 Section 1. Subsection (5) of section 408.034, Florida 27 Statutes, is amended, present subsection (6) of that section is 28 redesignated as subsection (7), and a new subsection (6) is 29 added to that section, to read: 30 408.034 Duties and responsibilities of agency; rules.— 31 (5) The agency shall establish by rule a nursing-home-bed 32 need methodology that has a goal of maintaining a subdistrict 33 average occupancy rate of 9294percentand that reduces the34community nursing home bed need for the areas of the state where35the agency establishes pilot community diversion programs36through the Title XIX aging waiver program. 37 (6) If nursing home bed need is determined to exist in 38 geographically contiguous subdistricts within a district, an 39 applicant may aggregate the subdistricts’ need for a new 40 community nursing home in one of the subdistricts. If need is 41 aggregated from two subdistricts, the proposed nursing home site 42 must be located in the subdistrict with the greater need as 43 published by the agency in the Florida Administrative Register. 44 However, if need is aggregated from more than two subdistricts, 45 the location of the proposed nursing home site must provide 46 reasonable geographic access for residents in the respective 47 subdistricts given the relative bed need in each. 48 Section 2. Subsection (2) and paragraphs (f), (k), (p), and 49 (q) of subsection (3) of section 408.036, Florida Statutes, are 50 amended to read: 51 408.036 Projects subject to review; exemptions.— 52 (2) PROJECTS SUBJECT TO EXPEDITED REVIEW.—Unless exempt 53 pursuant to subsection (3), the following projects are subject 54 toanexpedited reviewshallinclude, but not be limited to: 55 (a) A transfer of a certificate of need, except that when 56 an existing hospital is acquired by a purchaser, all 57 certificates of need issued to the hospital which are not yet 58 operational shall be acquired by the purchaser,without need for 59 a transfer. 60 (b) Replacement of a nursing home, if the proposed project 61 sitewithin the same district, if the proposed project site is62located within a geographic area that contains at least 6563percent of the facility’s current residents andis within a 30 64 mile radius of the replaced nursing home. 65 (c) Replacement of a nursing home within the same district, 66 if the proposed project site is outside a 30-mile radius of the 67 replaced nursing home but within the same subdistrict or a 68 geographically contiguous subdistrict. If the proposed project 69 site is in the geographically contiguous subdistrict, the prior 70 6-month occupancy rate for licensed community nursing homes for 71 that subdistrict must be at least 85 percent in accordance with 72 the agency’s most recently published inventory. 73 (d)(c)Relocation of a portion of a nursing home’s licensed 74 beds to a facility within the same district, if the relocation 75 is within a 30-mile radius of the existing facility and the 76 total number of nursing home beds in the district does not 77 increase. 78 (e)(d)The new construction of a community nursing home in 79 a retirement community as further provided in this paragraph. 80 1. Expedited review under this paragraph is available if 81 all of the following criteria are met: 82 a. The residential use area of the retirement community is 83 deed-restricted as housing for older persons as defined in s. 84 760.29(4)(b). 85 b. The retirement community is located in a county in which 86 25 percent or more of its population is age 65 and older. 87 c. The retirement community is located in a county that has 88 a rate of no more than 16.1 beds per 1,000 persons age 65 years 89 or older. The rate shall be determined by using the current 90 number of licensed and approved community nursing home beds in 91 the county per the agency’s most recent published inventory. 92 d. The retirement community has a population of at least 93 8,000 residents within the county, based on a population data 94 source accepted by the agency. 95 e. The number of proposed community nursing home beds in an 96 application does not exceed the projected bed need after 97 applying the rate of 16.1 beds per 1,000 persons aged 65 years 98 and older projected for the county 3 years into the future using 99 the estimates adopted by the agency reduced by, after100subtractingthe agency’s most recent published inventory of 101 licensed and approved community nursing home beds in the county 102per the agency’s most recent published inventory. 103 2. No more than 120 community nursing home beds shall be 104 approved for a qualified retirement community under each request 105for applicationfor expedited review. Subsequent requests for 106 expedited review under this process mayshallnot be made until 107 2 years after construction of the facility has commenced or 1 108 year after the beds approved through the initial request are 109 licensed, whichever occurs first. 110 3. The total number of community nursing home beds which 111 may be approved for any single deed-restricted community 112 pursuant to this paragraph mayshallnot exceed 240, regardless 113 of whether the retirement community is located in more than one 114 qualifying county. 115 4. Each nursing home facility approved under this paragraph 116 mustshallbe dually certified for participation in the Medicare 117 and Medicaid programs. 118 5. Each nursing home facility approved under this paragraph 119 mustshallbe at least 1 mile, as measured over publicly owned 120 roadways, from an existing approved and licensed community 121 nursing home, measured over publicly owned roadways. 1226. Section 408.0435 does not apply to this paragraph.123 6.7.A retirement community requesting expedited review 124 under this paragraph shall submit a written request to the 125 agency foranexpedited review. The request mustshallinclude 126 the number of beds to be added and provide evidence of 127 compliance with the criteria specified in subparagraph 1. 128 7.8.After verifying that the retirement community meets 129 the criteria for expedited review specified in subparagraph 1., 130 the agency shall publicly notice in the Florida Administrative 131 Register that a request for an expedited review has been 132 submitted by a qualifying retirement community and that the 133 qualifying retirement community intends to make land available 134 for the construction and operation of a community nursing home. 135 The agency’s notice mustshallidentify where potential 136 applicants can obtain information describing the sales price of, 137 or terms of the land lease for, the property on which the 138 project will be located and the requirements established by the 139 retirement community. The agency notice mustshallalso specify 140 the deadline for submission of theanycertificate-of-need 141 application, which mayshallnot be earlier than the 91st day or 142and not belater than the 125th day after the date the notice 143 appears in the Florida Administrative Register. 144 8.9.The qualified retirement community shall make land 145 available to applicants it deems to have met its requirements 146 for the construction and operation of a community nursing home 147 but maywillsell or lease the land only to the applicant that 148 is issued a certificate of need by the agency underthe149provisions ofthis paragraph. 150 a. A certificate of need application submitted under 151pursuant tothis paragraph mustshallidentify the intended site 152 for the project within the retirement community and the 153 anticipated costs for the project based on that site. The 154 application mustshallalso include written evidence that the 155 retirement community has determined that both the provider 156 submitting the application and the project satisfyproposed by157that provider satisfiesits requirements for the project. 158 b. If the retirement community determinescommunity’s159determinationthat more than one provider satisfies its 160 requirements for the project, it may notifydoes not preclude161the retirement community from notifyingthe agency of the 162 provider it prefers. 163 9.10.The agency shall review each submitted application 164submitted shall be reviewed by the agency. If multiple 165 applications are submitted for atheprojectaspublished 166 pursuant to subparagraph 7.8.,thenthe agency shall review the 167 competing applicationsshall be reviewed by the agency. 168 169 The agency shall develop rules to implement theprovisions for170 expedited review process, including time schedule, application 171 content thatwhichmay be reduced from the full requirements of 172 s. 408.037(1), and application processing. 173 (3) EXEMPTIONS.—Upon request, the following projects are 174 subject to exemption from the provisions of subsection (1): 175(f) For the creation of a single nursing home within a176district by combining licensed beds from two or more licensed177nursing homes within such district, regardless of subdistrict178boundaries, if 50 percent of the beds in the created nursing179home are transferred from the only nursing home in a county and180its utilization data demonstrate that it had an occupancy rate181of less than 75 percent for the 12-month period ending 90 days182before the request for the exemption. This paragraph is repealed183upon the expiration of the moratorium established in s.184408.0435(1).185 (j)(k)For the addition of nursing home beds licensed under 186 chapter 400 in a number not exceeding 10 total beds or 10 187 percent of the number of beds licensed in the facility being 188 expanded, whichever is greater; or, for the addition of nursing 189 home beds licensed under chapter 400 at a facility that has been 190 designated as a Gold Seal nursing home under s. 400.235 in a 191 number not exceeding 20 total beds or 10 percent of the number 192 of licensed beds in the facility being expanded, whichever is 193 greater. 194 1. In addition to any other documentation required by the 195 agency, a request for exemption submitted under this paragraph 196 must certify that: 197 a.Certify thatThe facility has not had any class I or 198 class II deficiencies within the 30 months preceding the request 199for addition. 200 b.Certify thatThe prior 12-month average occupancy rate 201 for the nursing home beds at the facility meets or exceeds 9496202 percent. 203 c.Certify thatAny beds authorized for the facility under 204 this paragraph before the date of the current request for an 205 exemption have been licensed and operational for at least 12 206 months. 207 2. The timeframes and monitoring process specified in s. 208 408.040(2)(a)-(c) apply to any exemption issued under this 209 paragraph. 210 3. The agency shall count beds authorized under this 211 paragraph as approved beds in the published inventory of nursing 212 home beds until the beds are licensed. 213 (o)(p)For replacement of a licensed nursing home on the 214 same site, or within 53miles of the same site, if the number 215 of licensed beds does not increase. 216 (p)(q)For consolidation or combination of licensed nursing 217 homes or transfer of beds between licensed nursing homes within 218 the same planning districtsubdistrict, byproviders that219operate multiplenursing homes with any shared controlled 220 interest within that planning districtsubdistrict, if there is 221 no increase in the planning districtsubdistricttotal number of 222 nursing home beds and the site of the relocation is not more 223 than 30 miles from the original location. 224 Section 3. Section 408.0435, Florida Statutes, is repealed. 225 Section 4. This act shall take effect July 1, 2014.