STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION 2014 t.1.T 18 /.\ lC: OW

WINKLER COURT,

vs.

Petitioner,

Case No.: 09-5503

Engagement No.: NH06-099C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No: 264008

RENDITION NO.: AHCA- ) 4 - 072_1 -5-MDA

Respondent.

I

WALDEMERE PLACE,

Petitioner,

vs.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Case No.: 09-5504

Engagement No.: NH06-095C Provider No.: 263982

Respondent.

I

WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER,

vs.

Petitioner,

Case No.: 09-5505

Engagement No.: NH06-108C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No: 263991

Respondent.

I

ABBEY REHABILITATION AND NURSING CENTER,

vs.

Petitioner,

Case No.: 09- 5507

Engagement No.: NH06-094C

STATE OF FLORIDA, AGENCY FOR Provider No.: 263958

1

Filed August 20, 2014 12:11 PM Division of Administrative Hearings

HEALTH CARE ADMINISTRATION,

Respondent.

I

BAY POINTE NURSING PAVILION,

vs.

Petitioner,

Case No.: 09-5508

Engagement No.: NH06-071C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No: 263834

Respondent.

I

BOCA RATON REHABILITATION CENTER,

vs.

Petitioner,

Case No.: 09-5509

Engagement No.: NH06-101C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No: 263842

Respondent.

I

CARROLL WOOD CARE CENTER,

vs.

Petitioner,

Case No.: 09-5510

Engagement No.: NH06-103C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 263877

Respondent.

I

CASA MORA REHABILITATION AND EXTENDED CARE,

vs.

Petitioner,

Case No.: 09-5511

Engagement No.: NH06-097C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No: 263885

Respondent.

I

EVERGREEN WOODS,

vs.

Petitioner,

Case No.: 09-5512

Engagement No.: NH06-109C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No: 263893

Respondent.

I

HEALTHCARE AND REHABILITATION CENTER OF SANFORD,

vs.

Petitioner,

Case No.: 09-5513

Engagement No.: NH06-107C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 263931

Respondent.

I

HIGHLAND PINES REHABILITATION CENTER,

vs.

Petitioner,

Case No.: 09-5514

Engagement No.: NH06-100C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 263907

Respondent.

I

THE OAKS AT AVON,

vs.

Petitioner,

Case No.: 09-5515

Engagement No.: NH06-098C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No: 263966

Respondent.

I

POMPANO REHABILITATION AND NURSING CENTER,

vs.

Petitioner,

Case No.: 09-5516

Engagement No.: NH06-106X

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 263923

Respondent.

I

REHABILITATION AND HEALTHCARE CENTER OF CAPE CORAL,

vs.

Petitioner,

Case No.: 09-5517

Engagement No.: NH06-102C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 263869

Respondent.

I

REHABILITATION AND HEALTHCARE CENTER OF TAMPA,

Petitioner,

vs.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Case No.: 09-5518

Engagement No.: NH06-104C Provider No.: 263940

Respondent.

I

REHABILITATION AND NURSING CENTER OF BROWARD,

Petitioner,

vs.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Case No.: 09-5519

Engagement No.: NH06-096C Provider No: 262851

Respondent.

I

REHABILITATION CENTER OF THE PALM BEACHES,

vs.

Petitioner,

Case No.: 09-5520

Engagement No.: NH06-105C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 263915

Respondent.

I

TITUSVILLE REHABILITATION AND NURSING CENTER,

vs.

Petitioner,

Case No.: 09-5521

Engagement No.: NH06-072C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 263974

Respondent.

I

FINAL ORDER

THE PARTIES resolved all disputed issues and executed a Settlement Agreement. The parties are directed to comply with the terms of the attached settlement agreement. Based on the

foregoing, this file is CLOSED.

DONE and ORDERED on this the ----3_ day of J--+Ni

1_c..y....,....,_-..._.{_·

, 2014, m

Tallahassee, Florida.

/\ /'

f ' .'

C \ ).;'-(/ '((l /r-

ELIZABETH DUDEK, SECRETARY

(Agency for Health Care Admforstration

A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY ALONG WITH FILING FEE AS PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED.

(OPPOSING COUNSEL)

Peter A Lewis, Esquire

302 North Shannon Lakes Drive Suitel0l

Tallahassee, Florida 32309 (Via U.S. Mail)

Bureau of Health Quality Assurance 2727 Mahan Drive, Mail Station 9

Tallahassee, Florida 32308 (Interoffice Mail)

Stuart Williams, General Counsel Agency for Health Care Administration 2727 Mahan Drive

Building 3, Mail Station 3

Tallahassee, Florida 32308 (Interoffice Mail)

Shena Grantham, Chief Medicaid FFS Counsel

Agency for Health Care Administration 2727 Mahan Drive

Building 3, Mail Station 3

Tallahassee, Florida 32308 (Interoffice Mail)

Karen Chang, Bureau Chief Medicaid Program Analysis 2727 Mahan Drive

Building 2, Mail Station 21

Tallahassee, Florida 32308 (Interoffice Mail)

Agency for Health Care Administration Bureau of Finance and Accounting 2727 Mahan Drive

Building 2, Mail Station 14

Tallahassee, Florida 32308 (Interoffice Mail)

Zainab Day, Medicaid Audit Services Agency for Health Care Administration 2727 Mahan Drive, Mail Station 21

Tallahassee, Florida 32308 (Interoffice Mail)

Kristin M. Bigham

Office of the Attorney General The Capitol PL - 01 Tallahassee, FL 32399-1050 (Via US Mail)

State of Florida, Division of Administrative Hearings

The Desoto Building 1230 Apalachee Parkway

Tallahassee, Florida 32399-3060 (Via U.S. Mail)

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by U.S. Mail on this the of -;,;;-D, 2014.

Richard Shoop, Esquire Agency Clerk

State of Florida

Agency for Health Care Administration 2727 Mahan Drive, Building #3

Tallahassee, Florida 32308-5403

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

WINKLER COURT,

vs.

Petitioner,

PROVIDER No: 264008 ENGAGEMENT No.: NH06-099C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

WALDEMERE PLACE,

vs.

Petitioner,

PROVIDER No.: 263982 ENGAGEMENT No.: NH06-095C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER,

vs.

Petitioner,

PROVIDER No: 263991 ENGAGEMENT No.: NH06-108C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

ABBEY REHABILITATION AND NURSING CENTER,

Settlement Agreement

vs.

Petitioner,

PROVIDER No.: 263958 ENGAGEMENT No.: NH06-094C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

BAY POINTE NURSING PAVILION,

Petitioner, PROVIDER No: 263834 ENGAGEMENT No.: NH06-071C

vs.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

BOCA RATON REHABILITATION CENTER,

Petitioner,

vs. PROVIDER No: 263842

ENGAGEMENT No.: NH06-101C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

CARROLLWOOD CARE CENTER,

vs.

Petitioner,

PROVIDER No.: 263877 ENGAGEMENT No.: NH06-103C

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Respondent.

I

CASA MORA REHABILITATION AND EXTENDED CARE,

vs.

Petitioner,

PROVIDER No: 263885 ENGAGEMENT No.: NH06-097C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

EVERGREEN WOODS,

vs.

Petitioner,

PROVIDER No: 263893 ENGAGEMENT No.: NH06-109C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

HEALTHCARE AND REHABILITATION CENTER OF SANFORD,

vs.

Petitioner,

PROVIDER No.: 263931 ENGAGEMENT No.: NH06-107C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

HIGHLAND PINES REHABILITATION CENTER,

vs.

Petitioner, PROVIDER No.: 263907 ENGAGEMENT No.: NH06-100C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

THE OAKS AT AVON,

vs.

Petitioner,

PROVIDER No: 263966 ENGAGEMENT No.: NH06-098C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

POMPANO REHABILITATION AND NURSING CENTER,

vs.

Petitioner,

PROVIDER No.: 263923 ENGAGEMENT No.: NH06-106C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

REHABILITATION AND HEALTHCARE CENTER OF CAPE CORAL,

Petitioner, PROVIDER No.: 263869

ENGAGEMENT No.: NH06-102C

vs.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

REHABILITATION AND HEALTHCARE CENTER OF TAMPA,

vs.

Petitioner,

PROVIDER No.: 263940 ENGAGEMENT No.: NH06-104C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

REHABILITATION AND NURSING CENTER OF BROWARD,

vs.

Petitioner,

PROVIDER No: 263851 ENGAGEMENT No.: NH06-096C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

I

REHABILITATION CENTER OF THE PALM BEACHES,

vs.

Petitioner,

PROVIDER No.: 263915 ENGAGEMENT No.: NH06-105C

STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION,

Respondent.

I

TITUSVILLE REHABILITATION AND NURSING CENTER,

Petitioner,

vs. PROVIDER No: 263974

ENGAGEMENT No: NH06-072C

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

'I

SETTLEMENT AGREEMENT

Respondent, STATE OF FLORIDA, AGENCY FOR HEALTH CARE

ADMINISTRATION ("AHCA" or "the Agency"), and Petitioners, WINKLER COURT, WALDEMERE PLACE, WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER, ABBEY REHABILITATION AND NURSING CENTER, BAY POINTE NURSING PAVILION, BOCA RATON REHABILITATION CENTER, CARROLLWOOD CARE CENTER, CASA MORA REHABILITATION AND EXTENDED CARE, EVERGREEN WOODS, HEALTHCARE AND REHABILITATION CENTER OF SANFORD, HIGHLAND PINES REHABILITATION CENTER, THE OAKS AT AVON, POMPANO REHABILITATION AND NURSING CENTER, REHABILITATION AND HEALTHCARE CENTER OF CAPE CORAL, REHABILITATION AND HEALTHCARE CENTER OF TAMPA, REHABILITATION AND NURSING CENTER OF BROWARD, REHABILITATION CENTER OF THE

PALM BEACHES, TITUSVILLE REHABILITATION AND NURSING CENTER

("PROVIDERS"), by and through the undersigned, hereby stipulate and agree as follows:

1. This Agreement is entered into between the parties to resolve disputed issues arising from examination engagements NH06-71C, NH06-072C, NH06-94C, NH06-095C, NH06-096C, NH06-097C, NH06-098C, NH06-099C, NH06-100C, NH06-101C, NH06-102C, NH06-103C, NH06-104C, NH06-105C, NH06- l 06C, NH06-107C, NH06-108C, and NH06- 109C.

2. The PROVIDERS are Medicaid providers in the State of Florida operating a nursing home facility that was examined by the Agency.

3. In the examination engagement numbers NH06-096C, NH06-097, NH06-098C, NH06-099C, and NH06-100C, AHCA examined the PROVIDERS' cost reports, covering the examination period ending on December 31, 2003.

4. In the examination engagement numbers NH06-071C, NH06-072C, NH06-101C, NH06-102C, NH06-103C, NH06-104C, NH06-105C, NH06-106C, NH06-107C, and NH06- 108C, AHCA examined the PROVIDERS' cost reports, covering the examination period ending on January 31, 2004.

5. In the examination engagement numbers NH06-094C, NH06-095C, and NH06- 109C, AHCA examined the PROVIDERS' cost reports, covering the examination period ending on March 31, 2004.

6. In its subsequent Examination Reports, AHCA notified the PROVIDERS that Medicaid reimbursement principles required adjustment of the costs stated in the cost report. The Agency further notified the PROVIDERS of the adjustments AHCA was making to the cost reports.

7. In response to AHCA's Examination Reports, the PROVIDERS filed a timely petition for administrative hearing, and identified specific adjustments that it appealed. The PROVIDERS requested that the Agency hold the petition in abeyance in order to afford the parties an opportunity to resolve the disputed adjustments.

8. Subsequent to the petition for administrative hearing, AHCA and the PROVIDERS exchanged documents and discussed the disputed adjustments. As a result of the aforementioned exchanges, the parties agree to accept all of the Agency's adjustments that were

   subject to these proceedings as set forth in the Examination Reports, except for the following adjustments which the parties agree shall be changed or removed as set in the attached settlement letters, which are hereby incorporated by reference as Exhibit A.

9. In order to resolve this matter without further administrative proceedings, and to avoid incurring further costs, PROVIDERS and AHCA expressly agree the adjustment resolutions as set forth in paragraph 8 above completely resolve and settle this case and this agreement constitutes the PROVIDERS' withdrawal of their petition for administrative hearing, with prejudice.

10. After issuance of the Final Order, PROVIDERS and AHCA further agree that the Agency shall recalculate the per diem rates for the above-stated examination period and issue a notice of the recalculation. Where the PROVIDERS were overpaid, the PROVIDERS will reimburse the Agency the full amount of the overpayment within thirty (30) days of such notice. Where the PROVIDERS were underpaid AHCA will pay the PROVIDERS the full amount of the underpayment within forty-five (45) days of such notice.

    Payment shall be made to:

    AGENCY FOR HEALTH CARE ADMINISTRATION

    Medicaid Accounts Receivable -MS #14 2727 Mahan Drive, Building 2, Suite 200

    Tallahassee, Florida 32308

    
    

    Notice to the PROVIDERS shall be made to:

    
    

    Peter A. Lewis, Esquire

    Law Offices of Peter A. Lewis, P.L. 3023 North Shannon Lakes Drive, #101

    Tallahassee, Florida 32303

    
    

11. Payment shall clearly indicate it is pursuant to a settlement agreement and shall reference the audit/engagement number.

12. PROVIDERS agree that failure to pay any monies due and owing under the terms of this Agreement shall constitute PROVIDERS' authorization for the Agency, without further notice, to withhold the total remaining amount due under the terms of this agreement from any monies due and owing to the PROVIDERS for any Medicaid claims.

13. The parties are entitled to enforce this Agreement under the laws of the State of Florida, the Rules of the Medicaid Program, and all other applicable law.

14. This settlement does not constitute an admission of wrongdoing or error by the parties with respect to this case or any other matter.

15. Each party shall bear their respective attorneys' fees and costs, if any.

    
    

16. The signatories to this Agreement, acting in their representative capacities, are duly authorized to enter into this Agreement on behalf of the party represented.

17. The parties further agree a facsimile or photocopy reproduction of this Agreement shall be sufficient for the parties to enforce the Agreement. The PROVIDERS agree, however, to forward a copy of this Agreement to AHCA with original signatures, and understand that a Final Order may not be issued until said original Agreement is received by AHCA.

18. This Agreement shall be construed in accordance with the provisions of the laws of Florida. Venue for any action arising from this Agreement shall be in Leon County, Florida.

19. This Agreement constitutes the entire agreement between PROVIDERS and the AHCA, including anyone acting for, associated with or employed by them, concerning all matters and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between PROVIDERS and the AHCA other than as set forth herein. No modifications or waiver of any provision shall be valid unless a written amendment to the Agreement is completed and properly executed by the parties.

20. This is an Agreement of settlement and compromise, made in recognition that the parties may have different or incorrect understandings, information and contentions, as to facts and law, and with each party compromising and settling any potential correctness or incorrectness of its understandings, information and contentions as to facts and law, so that no misunderstanding or misinformation shall be a ground for rescission hereof.

21. Except with respect to any recalculation(s) described in paragraph 10 above, PROVIDERS expressly waive in this matter their right to any hearing pursuant to sections

    §§120.569 or 120.57, Florida Statutes, the making of findings of fact and conclusions of law by the Agency, and all further and other proceedings to which it may be entitled by law or rules of the Agency regarding these proceedings and any and all issues raised herein, other than enforcement of this Agreement. The PROVIDERS further agree the Agency shall issue a Final Order, which adopts this Agreement.

22. This Agreement is and shall be deemed jointly drafted and written by all parties to it and shall not be construed or interpreted against the party originating or preparing it.

\\ Jr,.KLFR C'Ol!R L

WAL0E 1ERE PLA<:t:.

WINDSOR WOODS Rt:IIABll.l l'ATIO ANO Hl:ALTHC Rt.: Ct:N l'ER. ABBE\ RHIA811.ITATIO'.'\ A,n St:Rs1,G Cf'-TF:R.

BA\' POIN·n !'l RSl G PAVll.1O'.'-,

80C'A RATO!'i Rf:IIABI UT ATIO:\ CE 'iTf.R. C'ARROI.LWOOD ('ARE ("}:!\'fER,

CASA MORA RF.HABll.lTATION ASD EXTf DED CARI-:. F\ •:R(aU..f.S WOODS.

HF.ALTH('ARE AND REHABILITATION CE Tt:lt OJ,' SA FORD, HIGIILAr-iD Pl ES Rf.HABILITA l lON CENT[R,

THE. OAKS AT AVON,

P0'1PA O RF:HARILlTAllO'.\ A'l> '\l RSl'G CE'\ fER. REHABILITATION A'D HEALTHCARE c• '.'iftR 01-· ('APE CORAL. REHABILITATIO!'i AND HEALTHC.\Rl CE TER ot· TA!\1PA.

REHABILITATION A.'.\D ,t RSl!\G CENTER Of BROWARl>.

REHABILITATIO?\ CE'.'iTER OF lHE PAL'.\1 BEAl Ht:s, A'.'il>

TITl' \"ILl F RFHABILI TIO!"lo A!',,,I) ,1 w.s1,G CE TEk.

Da11:J ---1:v·: - J._I . 20I 4

FLORIDA AGET'<liCY FOR HE.\.LTH ('ARE ADMIMSTRATION

'2n7 \fahan Dmc, !\1.1il St,,p t:

lJ.ll:.thas'.>\.·1:. rlunJ.1 :2JtJH-541l;

Datd 1(<{

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E"IGAC£'4EM So\: !',jH06-CJ71(- HO«H)72C; \HOb· ·!OtOo-1

Settlement A{rrtt111ent

P,1g.-11 uil.Z

General Counsel

Chie

Dated: _ji,Jy llf,(._ ,2014

1

Dated 3: 2014

ss1stant Attome

ENGAGEMENT Nos: NH06-071C-NH06-072C;NH06-94C-NH06-109C

Settlement Agreement Page 12 of12

Healthcare and

Rehab of Sanford

A NOT FOR PROFIT FACILITY

January 16, 2014

950 Mellonville

Avenue

,a1lfOI d, fit , '71

Phone: {407) 322-

8566

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Healthcare and Rehabilitation Center of Sanford

Audit Period/Engagement No.: January 31, 2004/NH06-107C/26393-1 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 2, 3, 4, 6, 8, 11, 12, 13, 14, 15, 22, 30, 38 and 44 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above.

gi«u·

Thank You,

l-

Julie C. Kleiser

Director of Reimbursement, Kane Financial Services, LLC

Exhibit A

The Abbey Rehabilitation

and Nursing Center

7101 Martin Luther King Jr. St. N

St. Petersburg, FL 33702

A NOT FOR PROFIT FACIL11Y Phone: (727) 527-7231

January 16, 2014 Zainab Day

Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: The Abbey Rehabilitation and Nursing Center

Audit Period/Engagement No.: March 31, 2004/NH06-094C/26395-8 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 2, 3, 5, 7, 9, 13, 14, 15, 16, 17, 18, 26, 35, 44 and 51 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement

Kane Financial Services, LLC

A Member of o Not For Profit Orgonlzotion

Exhibit

A

Boca Raton

Rehabilitation Center

January 16, 2014 Zainab Day

Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Boca Raton Rehabilitation Center

Audit Period/Engagement No.: January 31, 2004/NH06-101C/26384-2 Dear Ms. Day:

755 Meadows Road Boca Raton, FL 33486

<e-,•-M--••

Phone: (561) 391-5200

Fax: (561) 391-0685

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 3, 4, 5, 7, 9, 13, 14, 15, 23, 30, 38 and 44 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

A Member of a Not For Profit Organization

Exhibit

A

• Rehabilitation and Healthcare Center of Cape Coral

A NOT FOR PROFIT FACILITY

January 16, 2014 Zainab Day

Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Rehabilitation and Health Care Center of Cape Coral

Audit Period/Engagement No.: January 31, 2004/NH06-102C/26386-9 Dear Ms. Day:

2629 Del Prado Blvd. South CaQe Coral, FL

33904

Phone: (239) 574-

4434

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination

Report for the above provider be revised for adjustment numbers 1, 5, 6, 7, 9, 11, 15, 17, 18, 19, 20, 21, 31, 41, 51 and 59 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement, Kane Financial Services, LLC

Exhibit

A

Sarasota

Health & Rehabilitation Center

A NOT FOR PROFIT fAClUTY

January 16, 2014

1524 East Avenue

South 34239

Phone: (941) 365-

2422

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Waldemere Place

Audit Period/Engagement No.: March 31, 2004/NH06-095C/26398-2 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 4, 5, 8, 10, 12, 14, 15, 16, 24, 33, 42 and 49 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

Exhibit A

• :..T

) Winkler Court, LLC

Florida Institute for Long Term Care

\._ A ;\:OT FOR l'ROFIT CORl'OltHION

3250 Winkler Avenue Extension

Ft. Myers, FL 33916

Phone: 239-939-4993

Fax: 239-939-1743

January 16, 2014

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Winkler Court

Audit Period/Engagement No.: December 31, 2003/NH06-099C/26400-8 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 6, 7, 8, 10, 12, 14, 15, 16, 17, 18, 28, 37, 46 and 53 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

Exhibit

A

A Member of a Not Ff,r Profit Organization

•l

) Deerfield Beach

Health & Rehabilitation Center

January 16, 2014 Zainab Day

Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Rehabilitation and Nursing Center of Broward

Audit Period/Engagement No.: December 31, 2003/NH06-096C/26385-1 Dear Ms. Day:

401 E. Sample Road Deerfield Beach, FL 33064

Phone: 954-941-4100

Fax: 954-941-4233

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 6, 9, 12, 14, 16, 20, 21, 22, 35, 41, 47 and 52 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

Exhibit

A

/\ NOT FOR PROFIT FACILln'

Pompano

Health & Rehabilitation Center

January 16, 2014

51 W. Sampie Road

Deerfield Beach, FL 33064

Phone: 954-942-5530

Fax: 954-942-0941

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Pompano Rehabilitation and Nursing Center

Audit Period/Engagement No.: January 31, 2004/NH06-106C/26392-3 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 3, 4, 5, 7, 9, 12, 13,

14, 15, 16, 17, 24, 32, 40 and 46 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above.

Thank You,

e.

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

8 of 18

A NO r !OR l'ROl·I r h\Cll l'lY

www.pompanohealthandrehab.com

Exhibit

A

Oaks at Avon

A NOT FOR PROFIT FACILITY

January 16, 2014

1010 US 27 North Avon Park, FL

Phone: (863) 453-

5200

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: The Oaks at Avon

Audit Period/Engagement No.: December 31, 2003/NH06-098C/26396-6 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 4, 5, 6, 9, 11, 13, 15, 16, 17, 18, 25, 31, 37 and 42 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

(!_

Julie C. Kleiser

Exhibit

Director of Reimbursement Kane Financial Services, LLC

A

Highland Pines Rehabilitation and Nursing Center

A NOT FOR PROFIT FACILITY

1111 South Highland Avenue Clearwater, FL 33756

Phone: (727) 446-0581

January 16, 2014

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Highland Pines Rehabilitation Center

Audit Period/Engagement No.: December 31, 2003/NH06-100C/26390-7 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 4, 6, 7, 10, 12, 15, 17, 19, 20, 22, 32, 41, 50 and 57 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above.

Thank You,

l

Julie C. Kleiser

Director of Reimbursement, Kane Financial Services, LLC

Exhibit

A

Evergreen Woods Health and Rehabilitation Center

7045 Evergreen Woods Trail Spring Hill, FL 34608

A NOT FOR PROFIT FACILITY Phone: (352) 596-8371

January 16, 2014 Zainab Day

Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Evergreen Woods

Audit Period/Engagement No.: March 31, 2004/NH06-109C/26389-3 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 2, 3, 6, 9, 11, 14, 15, 16, 17, 18, 27, 36, 45 and 52 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement

Kane Financial Services, LLC Exhibit

A

-----------··························-···--

Casa Mora Rehabilitation and Extended Care

A NOT !'OR PROFIT fACI UTY

1902 59th Street West Bradenton, FL 34209

Phone: (941) 761-1000

January 16, 2014

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Casa Mora Rehabilitation and Extended Care

Audit Period/Engagement No.: December 31, 2003/NH06-097C/26388-5 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 3, 4, 5, 7, 9, 11, 12, 13, 21, 30, 39 and 46 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

·C,. KvL--

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

Exhibit

A

Carrollwood Care Center

15002 Hutchinson Road

Tampa, FL 33625

A NOT FOR PROFIT FACILITY Phone: (813) 960-1969

January 16, 2014

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Carrollwood Care Center

Audit Period/Engagement No.: January 31, 2004/NH06-103C/26387-7 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 2, 3, 4, 6, 8, 10, 11, 12, 13, 14, 24, 34, 44 and 52 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

- t

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement, Kane Financial Services, LLC

A Member of a Not For Profit Organization

Exhibit A

@) B ay Pointe Nursing Pavilion, LLC

l

420 I 3 I' t Street South St. Petersburg, FL 33712

Phone: 727.867.1104

Fax: 727.864.4627

January 16, 2014

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Bay Pointe Nursing Pavilion

Audit Period/Engagement No.: January 31, 2004/NH06-071C/26383-4 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 3, 4, 6, 8, 10, 14, 15, 16, 23, 31, 39 and 45 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

Exhibit

A

A Member t!f a Nol For Pro.fit Or!{a11i:.arion

l

) Windsor Woods Rehabilitation, u.c

Florida Institutefor Long Term Care

,\ NO I l'()\l l'l(OFI I' COHl'OILYI 101\

13719 Dallas Drive

Hudson, FL 34667

Phone: 727.862.6795

Fax: 727.863.8721

January 16, 2014

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Windsor Woods Rehabilitation and Healthcare Center

Audit Period/Engagement No.: January 31, 2004/NH06-108C/26399-1 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 2, 3, 4, 6, 9, 11, 13, 14, 23, 33, 43 and 57 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

Exhibit

A

A Member of a Not For Profit Organi:.arion

Titusville Rehabilitation and Nursing Center

1705 Jess Parrish Court Titusville, FL 32796

A NOT FOR PROFIT FACILITY Phone: (321) 269-5720

January 16, 2014 Zainab Day

Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Titusville Rehabilitation and Nursing Center

Audit Period/Engagement No.: January 31, 2004/NH06-072C/26397-4 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 4, 5, 7, 9, 13, 15, 18, 19, 20, 21, 32, 44, 56 and 66 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above.

c.

Thank You,

Julie C. Kleiser

Director of Reimbursement Kane Financial Services, LLC

A Member of a Not For Profit Organization

Exhibit A

Rehabilitation Center of The Palm Beaches

301 Northpointe Parkway West Palm Beach, FL 33407

A NOT FORPROFJT FACILITY Phone: (561) 712-1717

January 20, 2014 Zainab Day

Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Rehabilitation Center of Palm Beaches

Audit Period/Engagement No.: January 31, 2004/NH06-105C/26391-5 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 5, 7, 8, 11, 14, 17, 19, 20, 21, 23, 34, 44, 54 and 60 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Director of Reimbursement

Kane Financial Services, LLC Exhibit

A

111 Rehabilitation and Healthcare

Z Center of Tampa

A NOT FOR PROFIT FACILITY

4411 North Habana Avenue Tampa, FL 33614

Phone: (813) 827-2771

January 16, 2014

Zainab Day Audit Services

Agency for Health Care Administration 2727 Mahan Drive MS #21

Tallahassee, FL 32308

RE: Rehabilitation and Healthcare Center of Tampa

Audit Period/Engagement No.: January 31, 2004/NH06-104C/26394-0 Dear Ms. Day:

Per agreement between Errol Williams and me, we would like to propose that the Medicaid Examination Report for the above provider be revised for adjustment numbers 1, 2, 4, 6, 8, 10, 15, 16, 17, 18, 20, 29, 39, 49 and 57 as follows. The settlement stipulation can be prepared with the following agreed upon changes:

Please let me know if you have any questions about the above. Thank You,

Julie C. Kleiser

Exhibit

Director of Reimbursement Kane Financial Services, LLC

A

Docket for Case No: 09-005521

Orders for Case No: 09-005521