Current through Reg. 50, No. 187; September 24, 2024
(1) DETAILED
EMERGENCY ENVIRONMENTAL CONTROL PLAN. Each assisted living facility shall
prepare a detailed plan ("plan") to serve as a supplement to its Comprehensive
Emergency Management Plan, to address emergency environmental control in the
event of the loss of primary electrical power in that assisted living facility
which includes the following information:
(a)
The acquisition of a sufficient alternate power source such as a generator(s),
maintained at the assisted living facility, to ensure that current licensees of
assisted living facilities will be equipped to ensure ambient air temperatures
will be maintained at or below 81 degrees Fahrenheit for a minimum of
ninety-six (96) hours in the event of the loss of primary electrical power.
1. The required temperature must be
maintained in an area or areas, determined by the assisted living facility, of
sufficient size to maintain residents safely at all times and that is
appropriate for resident care needs and life safety requirements. For planning
purposes, no less than twenty (20) net square feet per resident must be
provided. The assisted living facility may use eighty percent (80%) of its
licensed bed capacity as the number of residents to be used in the calculation
to determine the required square footage. This may include areas that are less
than the entire assisted living facility if the assisted living facility's
comprehensive emergency management plan includes allowing a resident to
congregate when he or she desires in portions of the building where
temperatures will be maintained and includes procedures for monitoring
residents for signs of heat related injury as required by this rule. This rule
does not prohibit a facility from acting as a receiving provider for evacuees
when the conditions stated in Section
408.821, F.S. and subsection
59A-36.019(5),
F.A.C., are met. The plan shall include information regarding the area(s)
within the assisted living facility where the required temperature will be
maintained.
2. The alternate power
source and fuel supply shall be located in an area(s) in accordance with local
zoning and the Florida Building Code.
3. Each assisted living facility is unique in
size; the types of care provided; the physical and mental capabilities and
needs of residents; the type, frequency, and amount of services and care
offered; and staffing characteristics. Accordingly, this rule does not limit
the types of systems or equipment that may be used to achieve ambient
temperatures at or below 81 degrees Fahrenheit for a minimum of ninety-six (96)
hours in the event of the loss of primary electrical power. The plan shall
include information regarding the systems and equipment that will be used by
the assisted living facility and the fuel required to operate the systems and
equipment.
a. An assisted living facility in
an evacuation zone pursuant to Chapter 252, F, S. must maintain an alternative
power source and fuel as required by this subsection at all times when the
assisted living facility is occupied but is permitted to utilize a mobile
generator(s) to enable portability if evacuation is necessary.
b. Assisted living facilities located on a
single campus with other facilities under common ownership, may share fuel,
alternative power resources, and resident space available on the campus if such
resources are sufficient to support the requirements of each facility's
residents, as specified in this rule. Details regarding how resources will be
shared and any necessary movement of residents must be clearly described in the
emergency power plan.
c. A
multistory facility, whose comprehensive emergency management plan is to move
residents to a higher floor during a flood or surge event, must place its
alternative power source and all necessary additional equipment so it can
safely operate in a location protected from flooding or storm surge
damage.
(b) The
acquisition of sufficient fuel, and safe maintenance of that fuel at the
facility, to ensure that in the event of the loss of primary electrical power
there is sufficient fuel available for the alternate power source to maintain
ambient temperatures at or below 81 degrees Fahrenheit for a minimum of
ninety-six (96) hours after the loss of primary electrical power during a
declared state of emergency. The plan must include information regarding fuel
source and fuel storage.
1. Facilities must
store minimum amounts of fuel onsite as follows:
a. A facility with a licensed capacity of 16
beds or less must store 48 hours of fuel onsite.
b. A facility with a licensed capacity of 17
or more beds must store 72 hours of fuel onsite.
2. An assisted living facility located in an
area in a declared state of emergency area pursuant to Section
252.36, F.S. that may impact
primary power delivery must secure ninety-six (96) hours of fuel. The assisted
living facility may utilize portable fuel storage containers for the remaining
fuel necessary for ninety-six (96) hours during the period of a declared state
of emergency.
3. Piped natural gas
is an allowable fuel source and meets the onsite fuel supply requirements under
this rule.
4. If local ordinances
or other regulations limit the amount of onsite fuel storage for the assisted
living facility's location, then the assisted living facility must develop a
plan that includes maximum onsite fuel storage allowable by the ordinance or
regulation and a reliable method to obtain the maximum additional fuel at least
24 hours prior to depletion of onsite fuel.
(c) The acquisition of services necessary to
maintain, and test the equipment and its functions to ensure the safe and
sufficient operation of the alternate power source maintained at the assisted
living facility.
(d) The
acquisition and maintenance of a carbon monoxide alarm.
(2) SUBMISSION OF THE PLAN.
(a) Each new assisted living facility shall
submit the plan required under this rule prior to obtaining a
license.
(b) Each existing assisted
living facility that undergoes any additions, modifications, alterations,
refurbishment, renovations or reconstruction that require modification of its
systems or equipment affecting the facility's compliance with this rule shall
amend its plan and submit it to the county emergency management agency for
review and approval.
(3)
APPROVED PLANS.
(a) Each assisted
living facility must maintain a copy of its approved plan in a manner that
makes the plan readily available at the licensee's physical address for review
by a legally authorized entity. If the plan is maintained in an electronic
format, assisted living facility staff must be readily available to access and
produce the plan. For purposes of this section, "readily available" means the
ability to immediately produce the plan, either in electronic or paper format,
upon request.
(b) Within 30 days of
the approval of the plan from the county emergency management agency, the
assisted living facility shall submit in writing proof of the approval to the
Agency for Health Care Administration to
assistedliving@ahca.myflorida.com.
(c) The assisted living facility shall submit
a consumer-friendly summary of the emergency power plan to the Agency. The
Agency shall post the summary and notice of the approval and implementation of
the assisted living facility emergency power plans on its website within ten
(10) business days of the plan's approval by the county emergency management
agency and update within ten (10) business days of
implementation.
(4)
IMPLEMENTATION OF THE PLAN.
(a) Each assisted
living facility licensed prior to the effective date of this rule shall, no
later than June 1, 2018, have implemented the plan required under this
rule.
(b) Each new assisted living
facility shall implement the plan required under this rule prior to obtaining a
license.
(c) Existing assisted
living facilities that undergo any additions, modifications, alterations,
refurbishment, renovations or reconstruction that require modification of the
systems or equipment affecting the assisted living facility's compliance with
this rule shall implement its amended plan concurrent with any such additions,
modifications, alterations, refurbishment, renovations or
reconstruction.
(5)
POLICIES AND PROCEDURES.
(a) Each assisted
living facility shall develop and implement written policies and procedures to
ensure that the assisted living facility can effectively and immediately
activate, operate and maintain the alternate power source and any fuel required
for the operation of the alternate power source. The procedures shall ensure
that residents do not experience complications from fluctuations in ambient air
temperatures inside the facility. Procedures must address the care of residents
occupying the facility during a declared state of emergency, specifically, a
description of the methods to be used to mitigate the potential for heat
related injury including:
1. The use of
cooling devices and equipment;
2.
The use of refrigeration and freezers to produce ice and appropriate
temperatures for the maintenance of medicines requiring
refrigeration;
3. Wellness checks
by assisted living facility staff to monitor for signs of dehydration and heat
injury; and
4. A provision for
obtaining medical intervention from emergency services for residents whose life
safety is in jeopardy.
(b) Each assisted living facility shall
maintain the written policies and procedures in a manner that makes them
readily available at the licensee's physical address for review by a legally
authorized entity. If the policies and procedures are maintained in an
electronic format, assisted living facility staff must be readily available to
access the policies and procedures and produce the requested information. For
purposes of this section, "readily available" means the ability to immediately
produce the policies and procedures, either in electronic or paper format, upon
request.
(c) The written policies
and procedures must be readily available for inspection by each resident; each
resident's legal representative, designee, surrogate, guardian, attorney in
fact, or case manager; each resident's estate; and such additional parties as
authorized in writing or by law.
(6) REVOCATION OF LICENSE, FINES OR
SANCTIONS. For a violation of any part of this rule, the Agency for Health Care
Administration may seek any remedy authorized by Chapter 429, Part I, or
Chapter 408, Part II, F.S., including, but not limited to, license revocation,
license suspension, and the imposition of administrative fines.
(7) COMPREHENSIVE EMERGENCY MANAGEMENT PLAN.
(a) Assisted living facilities whose
comprehensive emergency management plan is to evacuate must comply with this
rule.
(b) Each facility whose plan
has been approved shall submit the plan as an addendum with any future
submissions for approval of its comprehensive emergency management
plan.
(8) NOTIFICATION.
(a) Within five (5) business days, each
assisted living facility must notify in writing, unless permission for
electronic communication has been granted, each resident and the resident's
legal representative:
1. Upon the initial
submission of the plan to the county emergency management agency that the plan
has been submitted for review and approval;
2. Upon final implementation of the plan by
the assisted living facility.
3.
Annual submissions and approvals of the plan do not require notification to
residents or their legal representatives unless a significant modification as
defined in Rule 59A-36.019, F.A.C., has been
made to the plan.
(b)
Each assisted living facility must maintain a copy of each notification set
forth in paragraph (a) above in a manner that makes each notification readily
available at the licensee's physical address for review by a legally authorized
entity. If the notifications are maintained in an electronic format, facility
staff must be readily available to access and produce the notifications. For
purposes of this section, "readily available" means the ability to immediately
produce the notifications, either in electronic or paper format, upon
request.
Rulemaking Authority 429.41, FS. Law Implemented 429.19,
429.41, FS.
New 3-26-18, Formerly
58A-5.036, Amended 7-1-19,
11-23-23.