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SB 804 — Nursing Homes
Last action — Laid on Table, companion bill(s) passed, see CS/CS/HB 1239 (Ch. 2022-61)
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed Senate
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4Passed House
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5To Executive
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6Enacted
This bill died with 2022 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
Nursing Homes; Specifying functions that do not constitute direct care staffing hours for purposes of required nursing home staffing ratios; revising nursing home staffing requirements; providing that eating assistance to residents provided by certain direct care staff counts toward certain minimum direct care staffing requirements; providing that an unsatisfied or undischarged adverse final judgment in connection with a nursing home facility becomes the responsibility and liability of a new owner if ownership of the facility is transferred, etc.
Bill Text
What changed in the latest version
372 added · 331 removed372 line(s) added, 331 removed.
Florida Senate - 2022 CS for CS for SB 804 By the CommitteesCommittee on Rules;Health Policy;
and HealthSenator Policy;Albritton 588-02938-22 2022804c1 A bill to be entitled An act relating to modernization of nursing home facility staffing;
and Senator Albritton 595-03642-22 2022804c2 A bill to be entitled An act relating to nursing homes;
providing construction;
providing that certain informationforms submittedfiled towith the agency isare discoverablenot confidential or exempt and may be discoverable and admissible in civil andor administrative proceedings;
requiring a licensee to provide written notice to any pending claimants or their attorneys of record within a specified timeframe after Page 1 of 1112 CODING:
Florida Senate - 2022 CS for CS for SB 804 595-03642-22588-02938-22 2022804c22022804c1 pending claimants or their attorneys of record within a specified timeframe after filing a change of ownership application with the agency;
revising provisions related to moratoriums on new admissions for facilities that fail to comply with minimum staffing requirements;
deleting a certain fine;
creating the Nursing Home Sustainability Task Force;
providing duties and membership of the task force;
requiring the task force to submit its recommendations to the agency, the Governor, and the Legislature by a specified date;
amending s.
651.118, F.S.;
making a technical change;
(18) “Resident care plan” means a written, comprehensive person-centeredPage care2 planof developed12 inCODING: accordance with 42 C.F.R.
s.
483.21(b) by an interdisciplinary team within 7 days after completion of a comprehensive assessment and with participation by the resident or the resident’s designee.
The resident care plan must be reviewed and revised after each comprehensive assessment, which may be a new admission assessment, an annual assessment, or an assessment after a significant change in status, and after a quarterly review assessment.
A resident care Page 2 of 11 CODING:
Florida Senate - 2022 CS for CS for SB 804 595-03642-22588-02938-22 2022804c22022804c1 planperson-centered includescare measurableplan objectivesdeveloped andin timeframesaccordance to meet the resident’s medical, nursing, mental, and psychosocial needs and preferences, and must describe the services to be furnished, maintained, and reviewed not less than quarterly by a registered nurse, with participation42 fromC.F.R. other facility staff and the resident or his or her designee or legal representative, which includes a comprehensive assessment of the needs of an individual resident;
thes. type and frequency of services required to provide the necessary care for the resident to attain or maintain the resident’s highest practicable physical, mental, and psychosocial well-being;
483.21(b) which is, maintained, and reviewed at least not less than quarterly by a registered nurse, with participation from other facility staff and the resident or his or her designee or legal representative.
The resident care plan must include, which includes a comprehensive assessment of the needs of an individual resident;
the type and frequency of services required to provide the necessary care for the resident to attain or maintain the highest practicable physical, mental, and psychosocial well-being;
“Direct care staff” means personsindividuals who, through interpersonal contact with residents or resident care management, provide care and services to allow residents to attain or maintain the highest practicable physical, mental, and psychosocial well-being,well-being. including, but not limited to, disciplines and professions that must be reported in accordance with 42 C.F.R.
The term includes, but is not limited to, disciplines and professions that must be reported in accordance with 42 C.F.R.
483.70(q) in the following categories of direct care servicesservices: of nursing, dietary, therapeutic, and mental health.
The(I) termPhysician. does not include a person whose primary duty is maintaining the physical environment of the facility, including, but not limited to, food preparation, laundry, and housekeeping.
Page(II) 3Nursing. of 11 CODING:
(III) Pharmacy.
(IV) Dietary.
Page 3 of 12 CODING:
Florida Senate - 2022 CS for CS for SB 804 595-03642-22588-02938-22 2022804c22022804c1 b.(V) Therapeutic.
“Facility(VI) assessment”Dental. means a process, performed in accordance with 42 C.F.R.
(VII) Podiatry.
(VIII) Mental health.
93 The term does not include individuals whose primary duty is maintaining the physical environment of the facility, including, but not limited to, food preparation, laundry, and housekeeping.
b.
“Facility assessment” means a process to determine the staff competencies that are necessary to provide the level and types of care needed for the facility’s resident population considering the types of diseases, conditions, physical and cognitive disabilities, overall acuity, and other pertinent factors that are present within that resident population.
Show all 130 changed lines (90 more)
Additional requirements for conducting a facility assessment must be performed in accordance with 42 C.F.R.
483.70(e),483.70(e). to determine the staff competencies necessary to provide the level and types of care needed for the facility’s resident population, considering the types of diseases, conditions, physical and cognitive disabilities, overall acuity, and other factors pertinent to that resident population.
For purposes of this subsection, direct care staffing hours do not include time spent on nursing administration, activities program administration, staff development, staffing coordination, and the administrative portion of the minimum data set and care plan coordination for Medicaid.
Each facility must determine its direct care staffing needs based on the facility assessment and the individual needs of aeach resident based on the resident’s care plan.
These requirements must includeinclude, the following, for each facility:
A minimum weekly average of certified nursing assistant and licensed nursing staffing combined of 3.6 hours of direct carePage by4 directof care12 staffCODING: per resident per day.
AsWords usedstricken inare thisdeletions; sub-subparagraph, a week is defined as Sunday through Saturday.
words underlined are additions.
Florida Senate - 2022 CS for SB 804 588-02938-22 2022804c1 care per resident per day.
As used in this subparagraph sub- subparagraph, a week is defined as Sunday through Saturday.
A facility may not staff below a ratio of one certified nursing assistant per 20 residents.
A facility may not staff below a ratio of one licensed nurse per 40 residents.
Page2. 4 of 11 CODING:
Words stricken are deletions;
words underlined are additions.
Florida Senate - 2022 CS for CS for SB 804 595-03642-22 2022804c2 2.
Unless otherwise approved by the agency,Page licensed5 nurses counted toward the minimum staffing requirements for certified nursing assistants must exclusively perform the duties of a12 certifiedCODING: nursing assistant for the entire shift and not also be counted toward the minimum staffing requirements for licensed nurses.
If the agency approved a facility’s request to use a licensed nurse to perform both licensed nursing and certified nursing assistant duties, the facility must allocate the amount of staff time specifically spent on certified nursing assistant duties for the purpose of documenting compliance with minimum staffing requirements for Page 5 of 11 CODING:
Florida Senate - 2022 CS for CSSB 804 588-02938-22 2022804c1 agency, licensed nurses counted toward the minimum staffing requirements for SBcertified 804nursing 595-03642-22assistants 2022804c2must exclusively perform the duties of a certified nursing assistant for the entire shift and licensednot nursingalso staff.be counted toward the minimum staffing requirements for licensed nurses.
If the agency approved a facility’s request to use a licensed nurse to perform both licensed nursing and certified nursing assistant duties, the facility must allocate the amount of staff time specifically spent on certified nursing assistant duties for the purpose of documenting compliance with minimum staffing requirements for certified and licensed nursing staff.
The nurse staffing requirements imposed in this paragraph are minimum nurse staffing requirements for nursing home facilities.
(c)(b) Paid feeding assistants and direct care nonnursing staff, other than certified nursing assistantsassistants, and licensed nurses, who have successfully completed the feeding assistant training program under s.
400.141(1)(v) and who provide nonnursing staff providing eating assistance to residents shall not count toward compliance with overall direct care minimum staffing hours but not the hours of direct care required for certified nursing assistants or licensed nurses.nurses standards.
Time(d)(c) spentLicensed bypractical certifiednurses nursing assistants or licensed nursesunder onchapter providing464 eatingwho assistanceprovide toare residentsproviding shallnursing countservices towardin the hours of direct care required for certified nursing assistantshome orPage licensed6 nursesof standards.12 CODING:
(d)(c)Words Licensedstricken practical nurses licensed under chapter 464 who provide are providingdeletions; nursing services in nursing home facilities under this part may supervise the activities of other licensed practical nurses, certified nursing assistants, and other unlicensed personnel providing services in such facilities in accordance with rules adopted by the Board of Nursing.
words underlined are additions.
Florida Senate - 2022 CS for SB 804 588-02938-22 2022804c1 facilities under this part may supervise the activities of other licensed practical nurses, certified nursing assistants, and other unlicensed personnel providing services in such facilities in accordance with rules adopted by the Board of Nursing.
400.0234 Availability of facility records for investigation Pageof 6resident’s ofrights 11violations CODING:and defenses;
Wordspenalty.— stricken(2) areForms deletions;filed with the agency pursuant to s.
words408.061(5) underlinedand (6) are additions.not confidential or exempt from the provisions of s.
Florida119.07(1) Senate - 2022 CS for CS for SB 804 595-03642-22 2022804c2 of resident’s rights violations and defenses;s.
penalty.—24(a), (2)Art. Information submitted pursuant to s.
408.061(5)I andof (6)the isState discoverableConstitution and may be discoverable and admissible in a civil action under this part or an administrative action under this part or part II of chapter 408.
Subsection (4) of section 400.024, Florida Statutes, is amended,amended and subsection (5) is added to that section, to read:
400.024 Failure to satisfy a judgment or settlement agreement;agreement.— (4) If, After the agency is placed on notice pursuant to subsection (2), the following applies and:
required notification to claimants.— (4) If, After the agency is placed on notice pursuant to subsection (2), the following applies and:
and (b) If a change of ownership application for the facility at issue is filed submitted by the licensee, by a person or entity identified as having a controlling interest in the licensee,Page or7 by a related party, the agency shall deny the change of ownership12 applicationCODING: unless compliance with this section is achieved.
(c) If an adverse final judgment under subsection (1) is entered but payment is not yet due and a change of ownership application for the facility at issue is submitted by the licensee, by a person or entity identified as having a controlling interest in the licensee, or by a related party, the adverse final judgment becomes the responsibility and liability of the transferee if the agency approves the change of ownership application.
(5) If a change of ownership application for the facility Page 7 of 11 CODING:
Florida Senate - 2022 CS for CS for SB 804 595-03642-22588-02938-22 2022804c22022804c1 atlicensee, issueor isby fileda byrelated party, the licensee,unsatisfied byor aundischarged personadverse orfinal entityjudgment identifiedunder assubsection having(1) abecomes controllingthe interestresponsibility inand liability of the licensee,transferee, orand bythe aagency relatedshall party,deny then:the change of ownership application unless compliance with this section is achieved.
(a)(c) TheIf licenseea orchange transferorof mustownership provideapplication writtenfor noticethe offacility theat filingissue ofis thefiled applicationby tothe eachlicensee, pendingby claimanta person or entity identified as having a controlling interest in the claimant’slicensee, attorneyor ofby record,a ifrelated applicable.party, then:
The1. written notice must be provided within 14 days after the date the application is filed with the agency.
(b) The licensee or transferor must provide written notice mustof bethe providedfiling byof certifiedthe mail,application returnto receipteach requested,pending claimant or otherthe methodclaimant’s thatattorney providesof verificationrecord, ofif receipt.applicable, within 14 days after the date the application is filed with the agency.
(c)2. A claimant has 30 days after the date of receipt of the written notice to object to the application if the claimant has reason to believe that the approval of the application would facilitate a fraudulent transfer or allow the transferor to avoid financial responsibility for the claimant’s pending claim.
(d) The agencywritten notice must considerbe anyprovided objectionby broughtcertified pursuantmail, toreturn thisreceipt subsectionrequested, in its decision to approve or denyother anmethod applicationthat forprovides changeverification of ownershipreceipt. under this part and part II of chapter 408.
(e)3. If a claim is pending in arbitration at the time that the application for change of ownership is filed, the claimant may file a petition to enjoin the transfer in circuit court.
(f)A Asclaimant usedhas in30 thisdays subsection,after the termdate “claimant”of meansreceipt aof resident or the resident’swritten familynotice orto personalobject representativeto whothe hasapplication notifiedif the licenseeclaimant orhas facilityreason ofto abelieve potentialthat claimthe byapproval writtenof noticethe ofapplication intentwould orfacilitate whoa hasfraudulent initiatedtransfer anor action,allow claim,the ortransferor arbitrationto proceedingavoid againstfinancial responsibility for the licenseeclaimant’s orpending facility.claim.
Section4. 5.
ParagraphsThe (g),agency (n),must andconsider (r)any ofobjection brought pursuant to this subsection (1)in Pageits 8decision to approve or deny an application for change of 11ownership CODING:under this part and part II of chapter 408.
5.
If a claim is pending in arbitration at the time that the application for change of ownership is filed, the claimant may file a petition to enjoin the transfer in circuit court.
6.
As used in this paragraph, “claimant” means a resident Page 8 of 12 CODING:
Florida Senate - 2022 CS for CS for SB 804 595-03642-22588-02938-22 2022804c22022804c1 or the resident’s family or personal representative who has notified the licensee or facility of sectiona 400.141,potential Floridaclaim Statutes,by arenotice amendedof tointent read:letter or who has initiated an action, claim, or arbitration proceeding against the licensee or facility.
Section 5.
Paragraphs (g), (n), and (r) of subsection (1) of section 400.141, Florida Statutes, are amended to read:
Compliance with the minimum staffing ratios must bePage based9 on the total number of residents12 receivingCODING: direct care services, regardless of where they reside on campus.
If the facility receives a conditional license, it may not share staff until the conditional license status ends.
This paragraph does not restrict the agency’s authority under federal or state law Page 9 of 11 CODING:
Florida Senate - 2022 CS for CS for SB 804 595-03642-22588-02938-22 2022804c22022804c1 tobe requirebased additionalon staffthe iftotal anumber facilityof isresidents citedreceiving fordirect deficiencies in care whichservices, areregardless caused by an insufficient number of certifiedwhere nursingthey assistantsreside oron licensedcampus. nurses.
If the facility receives a conditional license, it may not share staff until the conditional license status ends.
This paragraph does not restrict the agency’s authority under federal or state law to require additional staff if a facility is cited for deficiencies in care which are caused by an insufficient number of certified nursing assistants or licensed nurses.
AThe facilityagency thatmay hasimpose faileda tomoratorium complyon withnew stateadmissions minimum-for staffinga requirementsfacility that has failed for 48 2 consecutive hours daysto iscomply prohibitedwith fromthe acceptingminimum newhours admissionsof untildirect thecare facilityrequired hasto achievedbe theprovided minimum-staffingby requirementsa forlicensed 6nurse consecutiveor days.certified nursing assistant.
The moratorium may be imposed until the facility is able to document compliance with the minimum direct care hours required per resident per day for licensed nurses and certified nursing assistants state minimum-staffing requirements for 2 consecutive days is prohibited from accepting new admissions until the facility has achieved the minimum-staffing requirements for 6 consecutive days.
A facility that has a standard does not have a conditional license may be cited for failure to comply with the standardsPage in10 s.of 12 CODING:
Words stricken are deletions;
words underlined are additions.
Florida Senate - 2022 CS for SB 804 588-02938-22 2022804c1 standards in s.
only if it has failed to meet those standards for 48 on 2 consecutive hours days or if it has failed to meet at least 97 percent of those standards on any one day.
The direct care staff certified nursing assistant who is caring for the resident must complete Pagethis 10record by the end of 11his CODING:or her shift.
Words stricken are deletions;
words underlined are additions.
Florida Senate - 2022 CS for CS for SB 804 595-03642-22 2022804c2 this record by the end of his or her shift.
Nursing Home Sustainability Task Force.—There is created the Nursing Home Sustainability Task Force.
The task force shall review, analyze, and make recommendations specific to the sustainability of the state’s model of providing quality nursing home care.
The task force shall consist of representatives of nursing home providers and other interested stakeholders.
The task force shall review all areas of the provision of health care services to residents, regulation, liability, licensing, quality initiatives, and the availability of quality, affordable, and accessible health care.
The task force shall make any recommendations to the Agency for Health Care Administration, the Governor, the President of the Senate, Page 11 of 12 CODING:
Words stricken are deletions;
words underlined are additions.
Florida Senate - 2022 CS for SB 804 588-02938-22 2022804c1 and the Speaker of the House of Representatives by January 1, 2025.
Section 7.
Subsection (6) of section 651.118, Florida Statutes, is amended to read:
651.118 Agency for Health Care Administration;
certificates of need;
sheltered beds;
community beds.— (6) Unless the provider already has a component that is to be a part of the continuing care facility and that is licensed under chapter 395, part II of chapter 400, or part I of chapter 429 at the time of construction of the continuing care facility, the provider must construct the non-nursing nonnursing home portion of the facility and the nursing home portion of the facility at the same time.
If a provider constructs less than the number of residential units approved in the certificate of authority, the number of licensed sheltered nursing home beds shall be reduced by a proportionate share.
Section 8.
Page 1112 of 1112 CODING:
Show all 130 changed rows (90 more)
View plain text versions (3)
- S 804 c1 View text pdf
- S 804 c2 View text Current pdf
- Introduced S 804 Filed pdf
AI-generated reading aid from the bill's amendatory text — verify against the official bill.
The bill revises definitions and requirements related to nursing home staffing and establishes processes for ownership transfers and compliance notifications.
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Section 400.021
The resident care plan must be reviewed and revised after each comprehensive assessment, which may be a new admission assessment, an annual assessment, or an assessment after a significant change in status, and after a quarterly review assessment.→ The resident care plan must be reviewed and revised after each comprehensive assessment, which may be a new admission assessment, an annual assessment, or an assessment after a significant change in status.The review process for the resident care plan is streamlined to exclude quarterly review assessments.
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Section 400.23
A minimum certified nursing assistant staffing of 2.0 hours of direct care by a certified nursing assistant per resident per day.→ A minimum certified nursing assistant staffing of 2.5 hours of direct care by a certified nursing assistant per resident per day.The minimum requirement for certified nursing assistant staffing per resident per day is increased.
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Section 400.23
The agency must shall recognize the use of licensed nurses for compliance with minimum staffing requirements for certified nursing assistants.→ The agency shall recognize the use of licensed nurses for compliance with minimum staffing requirements for certified nursing assistants if the nursing home facility otherwise meets the minimum staffing requirements for licensed nurses and the licensed nurses are performing the duties of a certified nursing assistant.Licensed nurses can now be counted towards staffing requirements for certified nursing assistants under certain conditions.
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Section 400.23
Evidence that a facility complied with the minimum direct care staffing requirements under subparagraph 1. is not admissible as evidence of compliance with the nursing services requirements under 42 C.F.R. s. 483.35 or 42 C.F.R. s. 483.70.→ Evidence of compliance with state minimum staffing requirements is not admissible as evidence for compliance with specified provisions of federal law.Facilities cannot use compliance with state staffing requirements to prove compliance with federal regulations.
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Section 400.0234
Information submitted pursuant to s. 408.061(5) and (6) is discoverable and may be admissible in a civil action or an administrative action under this part or part II of chapter 408.
Certain information submitted to the agency can be used in legal proceedings.
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Section 400.024
If, After the agency is placed on notice pursuant to subsection (2), the f→ If an unsatisfied or undischarged adverse final judgment in connection with a nursing home facility becomes the responsibility and liability of a new owner if ownership of the facility is transferred.New owners of a nursing home facility inherit liability for existing adverse judgments.
Action History
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Laid on Table, companion bill(s) passed, see CS/CS/HB 1239 (Ch. 2022-61)
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Substituted CS/CS/HB 1239
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Read 2nd time
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Retained on Special Order Calendar
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CS/CS by Rules read 1st time
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Placed on Special Order Calendar, 03/03/22
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Placed on Calendar, on 2nd reading
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Pending reference review -under Rule 4.7(2) - (Committee Substitute)
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CS/CS by- Rules; YEAS 12 NAYS 4
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On Committee agenda-- Rules, 03/01/22, 1:30 pm, 412 Knott Building
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On Committee agenda-- Rules, 02/23/22, 9:00 am, 412 Knott Building --Temporarily Postponed
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CS by Health Policy read 1st time
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Now in Rules
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Remaining references corrected to Rules
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Original reference(s) removed: Community Affairs
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Pending reference review under Rule 4.7(2) - (Committee Substitute)
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CS by Health Policy; YEAS 9 NAYS 1
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On Committee agenda-- Health Policy, 02/10/22, 8:30 am, 412 Knott Building
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Introduced
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Referred to Health Policy; Community Affairs; Rules
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Filed
Sponsors
- Rules · Primary
- Health Policy · Primary
- Ben Albritton · Primary
Sponsorship breakdown
Export CSV (upgrade) →3 sponsors · 0 co-sponsors · 161 not signed on · 2 voted No
Sponsors (3)
- Rules
- Health Policy
- Albritton, Ben Republican
Co-sponsors (0)
None.
Not signed on (161)
161 members have not signed on to this bill.
Show all 161 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 5 | 1 | 0 | 0 |
| Unaffiliated | 7 | 3 | 0 | 1 |
| Total | 12 | 4 | 0 | 1 |
| % of votes cast | 71% | 24% | 0% | 6% |
How each member voted (17)
| Member | Party | Vote |
|---|---|---|
| Baxley | — | Yea |
| Bean | — | Yea |
| Book | — | Yea |
| Diaz | — | Yea |
| Hutson | — | Yea |
| Powell | — | Yea |
| Stargel | — | Yea |
| Bracy | — | Nay |
| Farmer | — | Nay |
| Gibson | — | Nay |
| Brandes | — | Not Voting |
| Albritton, Ben | Republican | Yea |
| Boyd, Jim | Republican | Yea |
| Garcia, Ileana | Republican | Nay |
| Gruters, Joe | Republican | Yea |
| Mayfield, Debbie | Republican | Yea |
| Passidomo, Kathleen | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 3 | 0 | 0 | 0 |
| Unaffiliated | 6 | 0 | 0 | 0 |
| Democrat | 0 | 1 | 0 | 0 |
| Total | 9 | 1 | 0 | 0 |
| % of votes cast | 90% | 10% | 0% | 0% |
How each member voted (10)
| Member | Party | Vote |
|---|---|---|
| Baxley | — | Yea |
| Bean | — | Yea |
| Book | — | Yea |
| Cruz | — | Yea |
| Powell | — | Yea |
| Diaz | — | Yea |
| Jones, Shevrin D. "Shev" | Democrat | Nay |
| Albritton, Ben | Republican | Yea |
| Brodeur, Jason | Republican | Yea |
| Garcia, Ileana | Republican | Yea |
Subjects
Frequently asked questions
- What does SB 804 do?
- Nursing Homes; Specifying functions that do not constitute direct care staffing hours for purposes of required nursing home staffing ratios; revising nursing home staffing requirements; providing that eating assistance to residents provided by certain direct care staff counts toward certain minimum direct care staffing requirements; providing that an unsatisfied or undischarged adverse final judgment in connection with a nursing home facility becomes the responsibility and liability of a new owner if ownership of the facility is transferred, etc.
- Who sponsors SB 804?
- SB 804 is sponsored by Rules, Health Policy, and Albritton, Ben (Republican).
- What is the current status of SB 804?
- This bill died with 2022 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track SB 804?
- Track SB 804 free on One Click Politics — get push/email alerts when it moves.
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