STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,
!t' · ....
. ..
,' . ;
vs.
Petitioner,
CASE NO.: 12-106PH AHCA NO.: 2011005869
DDJJ LLC d/b/a BRIARWOOD MANOR,
Respondent.
Formerly DOAH NO.: 11-4432
AHCA NO.: 2011009335
Formerly DOAH NO.: 11-5103
I
FINAL ORDER
Having reviewed the Administrative Complaint, and all other matters of record, the Agency for Health Care Administration finds and concludes as follows:
The Agency has jurisdiction over the above-named Respondent pursuant to Chapter 408, Part II, Florida Statutes, and the applicable authorizing statutes and administrative code provisions.
The Agency issued the attached Administrative Complaints and Election of Rights forms to the Respondent. (Ex. 1 and Ex. 2) The Election of Rights form advised of the right to an administrative hearing. The Respondent returned the Election of Rights forms selecting "Option 3." (Ex. 3 and Ex. 4) On October 17, 2011, the Administrative Law Judge entered an Order consolidating both cases (Ex. 5). On February 6, 2012, the Administrative Law Judge entered an Order granting the Agency's Motion to Relinquish Jurisdiction and Closing Files. (Ex. 6). On April 2, 2012, Richard J. Saliba, the Informal Hearing Officer, entered an Order Relinquishing Jurisdiction and Closing File based on Briarwood's decision that it was abandoning its request for a hearing (Ex. 7).
Based upon the foregoing, it is ORDERED:
The findings of fact and conclusions of law set forth in the Administrative Complaints are adopted and incorporated by reference into this Final Order.
The assisted living facility license of Briarwood Manor is REVOKED. The Respondent shall pay the Agency $35,500.00. If full payment has been made, the cancelled check acts as receipt of payment and no further payment is required. If full payment has not been made, payment is due within 30 days of the Final Order. Overdue amounts are subject to statutory interest and may be referred to collections. A check made payable to the "Agency for Health Care Administration" and containing the AHCA ten-digit case number should be sent to:
1
Filed June 26, 2012 11:00 AM Division of Administrative Hearings
Office of Finance and Accounting Revenue Management Unit
Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 14
Tallahassee, Florida 32308
ORDERED at Tallahassee, Florida, on this ay of_ (w_.L. R==.;:'. , 2012.
ek, Secretary
Agency for H 1th Care Administration
NOTICE OF RIGHT TO JUDICIAL REVIEW
A party who is adversely affected by this Final Order is entitled to 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 of 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.
CERTIFICATE OF SERVICE
I CERTIFY that a true and correct_qy;iy of this Final Order was served on the below-named persons by the method designated on this2 :f S=) ./ , 2012.
Richard S oop, Agency Cler
Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3
Tallahassee, Florida 32308-5403
Telephone: (850) 412-3630
Jan Mills Facilities Intake Unit (Electronic Mail) | Finance & Accounting Revenue Management Unit (Electronic Mail) |
Lourdes A. Naranjo, Senior Attorney Office of the General Counsel Agency for Health Care Administration (Electronic Mail) | Cindy Dookeran Administrator Briarwood Manor 5721-5631 N. W. 28th Street Lauderhill, Florida 33313 (U.S. Mail) |
Katrina Derico-Harris Medicaid Accounts Receivable Agency for Health Care Administration (Electronic Mail) | Arlene Mayo-Davis Field Office Manager Agency for Health Care Administration (Electronic Mail) |
Shawn McCauley Medicaid Contract Management Agency for Health Care Administration (Electronic Mail) | Errol H Powell Administrative Law Judge Division of Administration Hearings (Electronic Mail) |
Richard Saliba, Esq. Informal Hearing Officer Agency for Health Care Administration (Electronic Mail) |
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,
Petitioner,
v.
AHCA No.: 2011005869
Return Receipt Requested: 7009 0080 0000 0586 1985
DDJJ LLC d/b/a BRIARWOOD MANOR,
Respondent.
I
ADMINISTRATIVE COMPLAINT
COMES NOW State of Florida, Agency for Health Care Administration ("AHCA"), by and through the undersigned counsel, and files this administrative complaint against DDJJ LLC d/b/a Briarwood Manor (hereinafter "Briarwood Manor"), pursuant to Chapter 429, Part I, and Section 120.60, Florida Statutes (2010), and alleges:
NATURE OF THE ACTION
This is an action to revoke the assisted living facility license of Respondent [License No.: 7 4 7 8] , pursuant to Section 408.815(1)(c)&(d), Florida Statutes, and Section 429.14(1)(e), Florida Statutes, and to impose an administrative fine of $14,500.00, pursuant to Sections 429.14 and 429.19, Florida Statutes (2010), for the protection of public health,
EXHIBIT 1
safety and welfare. Section 429.14(1)(e), Florida Statutes, provides that the Agency may revoke an assisted living facility license if the facility is cited with three or more Class II deficiencies. The Agency has considered the factors outlined in Section 419.19(3), Florida Statutes, in imposing the penalty and in fixing the amount of the fine.
JURISDICTION AND VENUE
This Court has jurisdiction pursuant to Sections
120.569 and 120.57, Florida Statutes (2010), and Chapter 28-106, Florida Administrative Code (2010).
Venue lies pursuant to Rule 28-106.207, Florida
Administrative Code (2010).
PARTIES
AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing assisted living facilities pursuant to Chapter 429, Part I, Florida Statutes (2010), and Chapter 58A-5 Florida Administrative Code (2010).
Briarwood Manor operates a 34-bed assisted living
fac·i1·ity
located
at 5621-5631 N. W.
28t h Street, Lauderhi'll,
Florida 33313. Briarwood Manor is licensed as an assisted living facility under license number 7478. Briarwood Manor was at all
times material hereto a licensed facility under the licensing authority of AHCA and was required to comply with all applicable rules and statutes.
COUNT I
BRIARWOOD MANOR FAILED TO KEEP RESIDENTS' MEDICATIONS LOCKED IN THE REFRIGERATOR.
RULE SSA-5.0185(6) (b)l, FLORIDA ADMINISTRATIVE CODE (MEDICATION STANDARDS)
CLASS II VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
Briarwood Manor was cited with five (5) Class II deficiencies as a result of an Operation Spot Check Appraisal visit that was conducted on May 20, 2011.
An Operation Spot check appraisal visit was conducted on May 20, 2011. Based on observation and interview, it was determined that the facility did not keep residents' #1 and #4's medications locked within the refrigerator in the kitchen to ensure residents did not ingest potentially harmful medications. The findings include the following.
In an observation on 5-20-11 at 9:30 AM in the main kitchen, inside a non-lockable refrigerator and not in a lockable container, there were 2 boxes containing Risperdal
50mcg suspension, each marked for intramuscular administration for residents #1 and resident #4.
During this observation, it was determined the area where this refrigerator was located could not be locked and it was accessible by the general facility population of residents without encumbrances.
Based on the foregoing facts, Briarwood Manor violated Rule 58A-5.0185(6) (b)1, Florida Administrative Code, herein classified as a Class II violation, which warrants an assessed fine of $1,000.00 and gives rise to the revocation of the assisted living facility license.
COUNT II
BRIARWOOD MANOR FAILED TO MAINTAIN A SAFE .AND SANITARY FOOD SERVICE .AND KITCHEN AREA.
RULE SBA-5.020(1) (b), FLORIDA ADMINISTRATIVE CODE (NUTRITION .AND DIETARY STANDARDS)
CLASS II VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
An Operation Spot check appraisal visit was conducted on May 20, 2011. Based on observations, it was determined the facility failed to maintain a safe and sanitary food service and kitchen area. The findings include the following.
Observations on 5/20/11 at approximately 9:15 AM revealed the following concerns in the kitchen area:
The kitchen floor was dirty throughout, with a heavy layer of soil built up behind the three compartment sink area, equipment, and food storage area.
The kitchen stovetop, cabinet under sink, food equipment shelving, potholders, utensil drawers, switch plates, walls and window sills were dirty.
Cutting boards were blackened and deeply scored.
Several kitchen refrigerators were missing thermometers. The microwave oven door was rust laden and the microwave was soiled in the interior.
The deep chest freezer, which was full of frozen food, had a large build-up of ice, needed defrosting, and had no thermometer in the interior.
The dirty window sill directly about the 3 compartment sink continued uncovered single serve plastic utensils, dirty scrub pads, brushes, measuring cups and a ladle.
The kitchen back door was not vermin-proof as the door did not fit in the frame tightly. Live roaches were observed in the kitchen.
There were paints and chemicals stored within the
food storage room.
Approximately 10 lbs. of ground beef was left in a sheet pan defrosting on a kitchen table.
There was a bucket of dirty dishes on the table alongside the ground meat. Various clean cooking vessels were stored on a shelf underneath this table.
Note: A representative from the Department of Health was on the premises on 5/20/11 and issued an unsatisfactory food service inspection report to the facility.
Based on the foregoing facts, Briarwood Manor violated Rule SBA-5.020(1)(b), Florida Administrative Code, herein classified as a Class II violation, widespread, which warrants an assessed fine of $5,000.00 and gives rise to the revocation of the assisted living facility license.
COUNT III
BRIARWOOD MANOR FAILED TO MAINTAIN A RESIDENTIAL AREA WHICH PROMOTED A RESIDENTIAL, HOMELIKE, AND SAFE CARING ENVIRONMENT FOR RESIDENTS; FAILED TO PROVIDE A SAFE AND DECENT ENVIRONMENT WITH RESPECT TO PERSONAL DIGNITY AND PRIVACY; AND FAILED TO ENSURE THAT FURNITURE AND FURNISHINGS WERE CLEAN AND IN GOOD REPAIR
SECTION 429.28(1) (a), FLORIDA STATUTES
RULE SSA-5.023(3) (a)l. & 2., FLORIDA ADMINISTRATIVE CODE (PHYSICAL PLANT STANDARDS)
CLASS II VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
An Operation Spot check appraisal visit was conducted on May 20, 2011. Based on observations and interviews, it was determined that the facility failed to maintain a residential area which promoted a residential, homelike, and safe care environment for the census of 27 residents, and failed to provide a safe an decent environment with respect to dignity and privacy as required by the Residents' Bill of Rights. The facility also failed to ensure that furniture and furnishings were clean, functional, and in good repair. The findings include the following.
During the tour of the facility on 05/21/11 at 9:30
a.m. in the resident bathroom located in Building A adjacent to room 5, the bathroom door was observed to be open. There were residents observed in the vicinity. Inside the bathroom was a large hole in the tile wall where the sink used to be. There was a pipe coming out of the hole in the wall and a large bucket positioned under the pipe as the pipe was leaking water. The bucket was observed to be full of dirty water. The hole in the wall had jagged edges, was approximately two to three feet wide, about two feet high and at least a foot or more deep, exposing bare blackened dirt and debris.
The area also was moisture laden from the leaking pipe. There were broken tiles littering the area, exposed metal piping and water valves from the missing sink. The floor under
the bucket was also missing several tiles (a square area of approximately two feet by two feet) and exposing the brown sub floor. The brown sub floor was noted to be blackened with biogrowth. The bathroom door was observed open with no barrier or signage to alert residents, staff and visitors to the hazard.
Adjacent to the bathroom in Building A by room 5 was a storage closet that was easily opened, and not locked. Inside the closet there were construction materials, a green garden hose, buckets, and 2 containers of pesticides.
The maintenance staff member was interviewed on 05/20/11 at 9:45 a.m. He said that he is in the process of working on the sink and confirmed that the bathroom door was open. In addition, he confirmed that there was no lock on the storage closet adjacent to the bathroom and said he would find a way to lock it. The facility has a Limited Mental Health license and the census on the day of the survey was 27.
During observations on 05/20/11 at 10:30 a.m. in the
laundry room in Building B there was a ladder and construction materials observed stored behind the door. There was a silver air conditioning (a/c) duct running along the wall just below the ceiling that was noted to have a large hole, exposing the insulation. The edges were blackened. There was a large shelving unit with folded blankets and comforters stored right below the a/ c duct and next to the ladder and construction materials. In
addition, the a/c vent just above the clean linens was observed to be dirty, and blowing directly onto the folded linens. The laundry room floor was filthy. This was brought to the attention of the maintenance staff member.
During observations on 05/20/11 at approximately 10:45 a.rn. in the resident bathroom in Building A on the North side of the building the tub was observed to have no faucet. Instead there was just a bare metal thin spout with a sharp metal end corning out of the tub. In addition, the tub was very dirty. This was brought to the attention of the maintenance staff member.
On 05/20/11 at approximately 10:00 a.rn. in Building B the bathroom outside room 11 was observed to be very dirty with a dried brownish substance smeared in places on the floor. On 05/20/11 at 11:00 a·.m., about an hour later, the substance was noted to still be there.
Observations of Room 3 and 4 at approximately 10:30 AM on 5/20/11 revealed the rooms were adjoined together through the closet opening of room 3. A torn plastic shower curtain was hung at the opening in room 3 and the resident's bed in room 3 was placed in front of the shower curtain blocking access between rooms 3 and 4.
Room 4 had no window to the outside and was occupied by resident #4. Observations of room 4 on 5/20/11 revealed the room was dark, dreary, dimly lit, musty, warm, and difficult to
maneuver around in. There was no closet either in room 3 and 4.
A referral was made to the City of Lauderhill Code Enforcement officer, who was present during the survey. The Code Enforcement Unit issued the facility a "Notice of Violation" on 5/20/11 with numerous violations.
A referral was made to the Broward County Health Department. Their representative arrived at the facility during the survey and issued an unsatisfactory inspection report to the facility.
During the tour of the facility on 05/20/11 at 9:30 a.rn. the following was observed with the maintenance staff member.
In Building A room 4, there was a lamp with no shade and the bare bulb was exposed.
In Building A's day room, the window curtains were observed to be soiled and not hanging properly as many of the curtain hooks were not attached to the rod and hanging loosely. In the bathroom on the North side of Building A the vanity cabinet was observed to be in disrepair as it was separating from the wall.
In Building B, the bathroom off the day room was observed to have window blinds that were in disrepair. The sink vanity was in disrepair as the veneer was peeling off and worn. The toilet tank lid had a large crack in the middle. The shower
curtain was torn and the floor was very dirty with black scuff marks and a large puddle of water.
In Building B, the bathroom adjacent to room 11 was very dirty including old feces on the floor.
A leather sofa in the common area in Building B had a large tear in the cushion.
The bathroom outside room 13 was observed to have a very dirty floor, a hole behind the toilet, and a rusty opened can of food was found stored inside the mirrored vanity door.
The administrator was interviewed on 05/20/11 at 11:30 a.rn. and no additional information was provided.
Based on the foregoing facts, Briarwood Manor violated Rule 58A-5.023(3)(a)1. & 2., Florida Adrninistrati ve Code, and Section 42 9. 28(1)(a), Florida Statutes, herein classified as a Class II violation, widespread, which warrants an assessed fine
of $5,000.00 and gives rise to the revocation of the assisted living facility license.
COUNT IV
BRIARWOOD MANOR FAILED TO ENSURE THAT THE DOORS WERE FUNCTIONAL AND IN GOOD WORKING ORDER, AND THAT PEELING PAINT WAS REPAIRED OR REPLACED.
RULE SSA-5.023(3) (a)3, FLORIDA ADMINISTRATIVE CODE (PHYSICAL PLANT STANDARDS)
CLASS II VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
An Operation Spot check appraisal visit was conducted on May 20, 2011. Based on observations and interviews, it was determined that the facility failed to ensure that doors were functional and in good working order, and that peeling paint was repaired or replaced. The findings include the following.
During the tour of the facility on 05/20/11 at 9:30
a.m. the following was observed:
In Building A room 4, observations revealed the room had a door to the outside of the facility. The door was observed to be ill fitting, so that a large gap was between the door and the door jamb.
In Building B room 10, there was a door to the outside that had a large gap between the door and the door jamb, allowing the potential for insect infestations.
In Building B room 14, there was a door to the outside that did not fit the door jamb so that there was a large gap.
In Building B, the bathroom by the large paint storage closet was labeled with a sign that said the bathroom was out of order due to the bathtub leaking.
During the tour of the facility on 05/20/11 at 09:30
a.m. in Building A room 4, there was peeling paint on the walls.
In addition, throughout Building B the walls were observed to be patched and not painted over in several places throughout the building. The maintenance staff member was present and confirmed the findings.
The maintenance staff person was present during the observations on 05/20/11 and confirmed the findings.
Based on the foregoing facts, Briarwood Manor violated Rule 58A-5. 023 (3) (a) 3, Florida Administrative Code, herein classified as a Class II violation, patterned, which warrants an assessed fine of $2,500.00 and gives rise to the revocation of the assisted living facility license.
COUNT V
BRIARWOOD MANOR FAILED TO HAVE A SATISFACTORY HEALTH DEPARTMENT INSPECTION.
RULE SSA-5.016(6), FLORIDA ADMINISTRATIVE CODE RULE SSA-5.0161(1), FLORIDA ADMINISTRATIVE CODE
(PHYSICAL PLANT STANDARDS) CLASS II VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (5) as if fully set forth herein.
An Operation Spot check appraisal visit was conducted on May 20, 2011. Based on record reviews and interviews, it was determined that the facility failed to have a satisfactory health department inspection. The findings include the following.
. During observations of multiple physical plant issues at the facility, a referral was made to the Broward County on 05/20/11 at approximately 9:45 a.m. The Health Department representative arrived at the facility and was apprised of all of the findings of the survey team. At the conclusion of their visit the facility was issued an unsatisfactory Group Care and Food Service inspection on 05/20/11.
Based on the foregoing facts, Briarwood Manor violated Rule 58A-5.016(6), Florida Administrative Code, and Rule 58A- 5.0161(1), Florida Administrative Code herein classified as a Class II violation, which warrants an assessed fine of $1,000.00
and gives rise to the revocation of the assisted living facility license.
CLAIM FOR RELIEF
WHEREFORE, the Agency requests the Court to order the following relief:
Enter a judgment in favor of the Agency for Health Care Administration against Briarwood Manor on Counts I through VI.
Revoke the assisted living facility license [License No.: 7 4 78] of Briarwood Manor on Counts I through V for the violations cited above.
Assess an administrative fine of $14,500.00 against Briarwood Manor on Counts I through V for the violations cited above.
Assess costs related to the investigation and
prosecution of this matter, if the Court finds costs applicable.
Grant such other relief as this Court deems is just and proper.
Respondent is notified that it has a right to request an
administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes (2010). Specific options for administrative action are set out in the attached Election of Rights. All
requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, MS #3, Tallahassee, Florida 32308.
RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY.
IF YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY IN THIS MATTER
Fla. Bar No.: 997315
Assistant General Counsel Agency for Health Care Administration
8333 N.W. 53r d Street
Suite 300
Miami, Florida 33166
305-718-5906
Copies furnished to:
Arlene Mayo-Davis Field Office Manager
Agency for Health Care Administration 5150 Linton Blvd. - Suite 500
Delray Beach, Florida 33484 (U.S. Mail)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Cindy Dookeran, Administrator, Briarwood
Manor, 5621-5631 N. W.
,a
this 2{;, day of
Lauderhill, Florida 33313 on
Esq.
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
RE: DDJJ LLC d/b/a Briarwood Manor AHCA No.: 2011005869
ELECTION OF RIGHTS
This Election of Rights form is attached to a proposed action by the Agency for Health Care Administration (AHCA). The title may be Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine or Administrative Complaint.
Your Election of Rights must be returned by mail or by fax within 21 days of the day you receive the attached Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine or Administrative Complaint.
If your Election of Rights with your selected option is not received by AHCA within twenty one (21) days from the date you received this notice of proposed action by ARCA, you will have given up your right to contest the Agency's proposed action and a final order will be issued.
(Please use this form unless you, your attorney or your representative prefer to reply according to Chapter 120, Florida Statutes (2006) and Rule 28, Florida Administrative Code.)
PLEASE RETURN YOUR ELECTION OF RIGHTS TO THIS ADDRESS:
Agency for Health Care Administration Attention: Agency Clerk
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308.
Phone: 850-412-3630 Fax: 850-921-0158.
PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS
OPTION ONE (1) I admit to the allegations of facts and law contained in the Notice
of Intent to Impose a Late Fine or Fee, or Administrative Complaint and I waive my right to object and to have a hearing. I understand that by giving up my right to a hearing, a final order will be issued that adopts the proposed agency action and imposes the penalty, fine or action.
OPTION TWO (2) I admit to the allegations of facts contained in the Notice of Intent
to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or Administrative Complaint, but I wish to be heard at an informal proceeding (pursuant to Section 120.57(2), Florida Statutes) where I may submit testimony and written evidence to the Agency to show that the proposed administrative action is too severe or that the fine should be reduced.
OPTION THREE (3) I dispute the allegations of fact contained in the Notice of Intent
to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or Administrative Complaint, and I request a formal hearing (pursuant to Subsection 120.57(1), Florida Statutes) before an Administrative Law Judge appointed by the Division of Administrative Hearings.
PLEASE NOTE: Choosing OPTION THREE (3), by itself, is NOT sufficient to obtain a formal hearing. You also must file a written petition in order to obtain a formal hearing before the Division of Administrative Hearings under Section 120.57(1), Florida Statutes. It must be
received by the Agency Clerk at the address above within 21 days of your receipt ofthis proposed administrative action. The request for formal hearing must conform to the requirements of Rule 28- 106.2015, Florida Administrative Code, which requires that it contain:
Your name, address, and telephone number, and the name, address, and telephone number of your representative or lawyer, if any.
The file number of the proposed action.
A statement of when you received notice of the Agency's proposed action.
A statement of all disputed issues of material fact. If there are none, you must state that there are none.
Mediation under Section 120.573, Florida Statutes, may be available in this matter if the Agency agrees.
License type: (ALF? nursing home? medical equipment? Other type?)
Licensee Name: License number:
Contact person: _
Name Title
Address:. Street and number City Zip Code
Telephone No. Fax No. Email(optional) _
Ihereby certify that I am duly authorized to submit this Notice of Election of Rights to the Agency for Health Care Administration on behalf of the licensee referred to above.
Signed: Date:
Print Name: Title: _
Late fee/fine/AC
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,
Petitioner,
v.
AHCA No.: 2011009335
Return Receipt Requested: 7009 0080 0000 0586 2180
DDJJ LLC d/b/a BRIARWOOD MANOR,
Respondent.
I
ADMINISTRATIVE COMPLAINT
COMES NOW State of Florida, Agency for Health Care Administration ("AHCA"), by and through the undersigned counsel, and files this administrative complaint against DDJJ d/b/a Briarwood (hereinafter "Briarwood Manor"), pursuant to Chapter
429, Part I, and Section 120. 60, Florida Statutes (2010), and
alleges:
NATURE OF THE ACTION
This is an action to revoke the assisted living facility license of Respondent [License No.: 7478], pursuant to Section 408.815(1) (c)&(d), Florida Statutes, and Section
429.14 (1)(e)_, Florida Statutes, and to impose an administrative fine of $21,000.00 pursuant to Sections 429.14 and 429.19, Florida Statutes (2010), for the protection of public health,
EXHIBIT 2
safety and welfare. Section 429.14(1)(e), Florida Statutes, provides that the Agency may revoke an assisted living facility license if the facility is cited with one or more Class I deficiencies. Section 408.815(1)(c)&(d), Florida Statutes, provides that the Agency may revoke a license for a violation of "this part, authorizing statues, or applicable rules" or "for a demonstrated pattern of deficient practice". The Agency has considered the factors outlined in Section 419.19(3), Florida Statues, in imposing the penalty and fixing the amount of the fine.
JURISDICTION AND VENUE
This Court has jurisdiction pursuant to Sections
120.569 and 120.57, Florida Statutes (2010), and Chapter 28-106, Florida Administrative Code (2010).
Venue lies pursuant to Rule 28-106.207, Florida
Administrative Code (2010).
PARTIES
AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing assisted living facilities pursuant to Chapter 429,
Part I'
Flo.rlda Statutes (2010), and Chapter 58A-5 Florida
Administrative Code (2010).
Briarwood Manor operates a 34-bed assisted living facility located at 5621-5631 N. W. 28t h Street, Lauderhill, Florida 33313. Briarwood Manor is licensed as an assisted living facility under license number 7478. Briarwood Manor was at all times material hereto a licensed facility under the licensing
authority of AHCA and was required to comply with all applicable rules and statutes.
On August 17, 2011, the Agency entered an Immediate Moratorium on Admissions (AHCA No.: 20110090890) on the basis that the Agency determined that the current practices and conditions at Briarwood Manor present a threat to the health, safety, or welfare of the residents of the facility; present an immediate serious danger to the public, health, safety, or welfare; and present an immediate or direct threat to the health, safety, or welfare of the Residents who reside at
Briarwood Manor.
COUNT I
BRIARWOOD MANOR FAILED TO PROVIDE APPROPRIATE SUPERVISION FOR EACH RESIDENT INCLUDING GENERAL AWARENESS OF THE RESIDENT'S WHEREABOUTS, AND A WRITTEN RECORD AFTER A MAJOR INCIDENT.
RULE SSA-5.0182(1), FLORIDA ADMINISTRATIVE CODE (RESIDENT CARE - SUPERVISION STANDARDS)
CLASS I VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (6) as if fully set forth herein.
Briarwood Manor was cited with two (2) Class I deficiencies and one (1) Class II deficiency as a result of a survey conducted on August 11, 2011. On August 17, 2011, an
Immediate Moratorium on Admissions was served on Briarwood Manor
A survey was conducted on August 11, 2011. Based on Based on interview and record review, it was determined that the facility failed to provide appropriate supervision for each resident including: General awareness of the resident's whereabouts and a written record, updated after a major incident for 1 of 3 sampled residents reviewed (Resident #1). The findings include the following:
Record review on 8/11/11 revealed Resident #1 was
admitted to the facility on 1/22/09 with a diagnosis to include schizophrenia and renal cell cancer. A facility note on 7/20/11 documented the resident did not return to the facility until 2:00 AM. Note on 7/23/11 documented the resident did not return to the facility until 11:30 PM. On 7/28/11 the resident left the facility. A Resident Elopement Prevention Drill Form dated 7/29/11 at 7:00AM did not identify the employees who noticed the resident missing, the time she was last seen, employees who assisted in the search or a description of the resident. Further review of the record did not contain an incident report.
During an interview with the administrator on 8/11/11 at 10:45 AM, she stated the facility has not identified any
residents who may be at risk for elopement. She also stated the residents are not required to sign in or out when they leave the property as it is all done verbally. The surveyor was unable to determine the last time Resident #1 was seen at the facility.
A review with the administrator of the facility staffing schedule identifies one staff member working the 11:00 PM-7:00 AM shift. Two days a week the staff member working the overnight shift works a 16 hour double shift. During the review the administrator stated this is the facility's permanent schedule.
A review with the administrator of the policy and procedure manual did not identify a policy regarding resident supervision. A review of the elopement policy revealed the facility will: "conduct elopement drills with all the staff twice a year to protect our residents from elopement." "Any elopement will be documented in the resident file along with a copy of the adverse incident report. "A review of the elopement drills did not identify a drill in 2011 and only one drill in
2010.
During an interview on 8/11/11 at 11:46 AM with
several unsampled residents, they were asked if they had to notify anyone when they leave the facility's property. All the residents interviewed stated they did not need to notify anyone,
and they just needed to be back by 11:00 PM. As of 8/11/11 at 3:00 PM Resident #1 has not been found.
Based on the foregoing facts, Briarwood Manor violated Rule SSA-5.0182(1), Florida Administrative Code, herein classified as a Class I violation, which warrants an assessed fine of $10,000.00.
COUNT II
BRIARWOOD MANOR FAILED TO HAVE MEDICATIONS AVAILABLE TO ADMINISTER IN ACCORDANCE WITH HEALTH CARE PROVIDER'S ORDER OR PRESCRIPTION LABEL.
RULE SSA-5.0185(4)&(5), FLORIDA ADMINISTRATIVE CODE (MEDICATION ADMINISTRATION STANDARDS)
CLASS II VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (6) as if fully set forth herein.
A survey was conducted on August 11, 2011. Based on record review and interview, it was determined that the facility failed to have medications available to administer in accordance with a health care provider's order or prescription label, for 1 of 3 sampled residents reviewed (Resident #3). The findings include the following.
Resident #3 was admitted to the facility on 6/3/11 with a diagnosis to include Psychosis and COPD. An 1823 health assessment form completed by the physician on 6/14/11 identified
the residents medications to include Simvastin 40 mg 1 tab daily and Risperidone 4 mg 1 tablet HS. A review of the medication observation record (MOR) did not list the medications.
During an interview on 8/11/11 at 2:30 PM with the med tech, it was confirmed the MOR did not include Simvastin 40 mg 1 tab daily or Risperidone 4 mg 1 tablet HS. She acknowledged the facility did not have the medications and stated they were probably discontinued. The facility was not able to provide evidence the physician discontinued any of the resident's medications. The facility must maintain a daily medication evaluation record (MOR) for each resident who receives assistance with self-administration of medication or medication administration. The MOR must include a chart recording each time the medication is taken, any missed dosages, refusals to take medication, or medication errors. The MOR must be immediately updated each time the medication is offered or administered.
Based on the foregoing facts, Briarwood Manor violated
Rule SSA-5.0185(4)&(5), Florida Administrative Code, herein classified as a Class II violation, which warrants an assessed fine of $1,000.00.
COUNT III
BRIARWOOD MANOR FAILED TO ESTABLISH A RISK MANAGEMENT AND QUALITY ASSURANCE PROGRAM.
SECTION 429.23, FLORIDA STATUTES
RULE SSA-5.0241, FLORIDA ADMINISTRATIVE CODE (RISK MANAGEMENT AND QUALITY ASSURANCE STANDARDS) CLASS I VIOLATION
AHCA re-alleges and incorporates paragraphs ( 1)
through (6) as if fully set forth herein.
A survey was conducted on August 11, 2011. Based on record review and interview, it was determined that the facility failed to establish a risk management and quality assurance program, the purpose of which is to assess resident care practices, facility incident reports, and adverse incident reports, for 2 of 3 records reviewed (Resident #1 and #2). The findings include the following.
Record review on 8/11/11 revealed Resident #1 was admitted to the facility on 1/22/09 with a diagnosis to include schizophrenia and renal cell cancer. A facility note on 7/20/11 documented the resident did not return to the facility until 2:00 AM. Note on 7/23/11 documented the resident did not return to the facility until 11:30 PM. On 7/28/11 the resident left the facility. A Resident Elopement Prevention Drill Form dated 7/29/11 at 7:00 AM did not identify the employees who noticed the resident missing, the time she was last seen, employees who
assisted in the search or a description of the resident. Further review of the record did not contain an incident report.
During an interview with the administrator on 8/11/11 at 10:45AM, she stated the facility has not identified any residents who may be at risk for elopement. She also stated she faxed an adverse incident report to the agency on 7/29/11 but could not provide confirmation. At 10:55 AM the AHCA complaint unit was contacted and confirmed the agency had not received the required notification regarding the elopement.
The surveyor was unable to determine the last time Resident #1 was seen at the facility. As of 8/11/11 at 3:00 PM Resident #1 has not been found.
Resident #2 was admitted to the facility on 11/16/93 with a diagnosis to include Diabetes, COPD, and Neuropathy. A note dated 3/27/11 documents the resident was dizzy and fell. The resident was transferred to the hospital and returned to the facility on 3/30/11. During an interview on 8/8/11 at 1:45 PM with the administrator and med tech, it was revealed the med tech stated 911 was contacted and the resident was transported by ambulance to the local hospital. She could not remember what happened to the resident and did not complete an incident report.
Based on the foregoing facts, Briarwood Manor violated Section 429.23, Florida Statutes, and Rule 58A-5.0241, Florida
Administrative Code, herein classified as a Class I violation, which warrants an assessed fine of $10,000.00.
CLAIM FOR RELIEF
WHEREFORE, the Agency requests the Court to order the following relief:
Enter a judgment in favor of the Agency for Health Care Administration against Briarwood Manor on Counts I through III.
Revoke the assisted living facility license [License No.: 7478] of Briarwood Manor for the citations cited in counts I through III.
Assess an administrative fine of $21,000.00 against Briarwood Manor on Counts I through III for the violations cited above.
Assess costs related to the investigation and prosecution of this matter, if the Court finds costs applicable.
Grant such other relief as this Court deems is just and proper.
Respondent is notified that it has a right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes (2010). Specific options for administrative action are set out in the attached Election of Rights. All
requests for hearing shall be made to the Agency for Health Care Administration, and delivered to the Agency Clerk, Agency :for Hea1th Care Administration, 2727 Mahan Drive, MS #3,
Tallahassee, Florida 32308.
RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY.
r
IF YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY IN THIS MATTER
Lourdes A. Naranjo, Esq. Fla. Bar No.: 997315
Assistant General Counsel Agency for Health Care Administration
8333 N.W. 53r d Street
Suite 300
Miami, Florida 33166
Copies furnished to:
Arlene Mayo-Davis Field Office Manager
Agency for Health Care Administration 5150 Linton Blvd. - Suite 500
Delray Beach, Florida 33484 (U.S. Mail)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Cindy Dookeran, Administrator, Briarwood
Manor, 561-1-5631 N. W. t, Lauderhill, Florida 33313 on
thi. s
(rf; d ay of
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
RE: DDJJ LLC d/b/a Briarwood Manor AHCA No.: 2011009335
ELECTION OF RIGHTS
This Election of Rights form is attached to a proposed action by the Agency for Health Care Administration (AHCA). The title may be Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine or Administrative Complaint.
Your Election of Rights must be returned by mail or by fax within 21 days of the day you receive the attached Notice of Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine or Administrative Complaint.
If your Election of Rights with your selected option is not received by AHCA within twenty one (21) days from the date you received this notice of proposed action by AHCA, you will have given up your right to contest the Agency's proposed action and a final order will be issued.
(Please use this form unless you, your attorney or your representative prefer to reply according to Chapter 120, Florida Statutes (2006) and Rule 28, Florida Administrative Code.)
PLEASE RETURN YOUR ELECTION OF RIGHTS TO THIS ADDRESS:
Agency for Health Care Administration Attention: Agency Clerk
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308.
Phone: 850-412-3630 Fax: 850-921-0158.
PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS
OPTION ONE (1) I admit to the allegations of facts and law contained in the Notice
of Intent to Impose a Late Fine or Fee, or Administrative Complaint and I waive my right to object and to have a hearing. I understand that by giving up my right to a hearing, a final order will be issued-that adopts the proposed agency action and imposes the penalty, fine or action.
OPTION TWO (2) I admit to the allegations of facts contained in the Notice of Intent
to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or Administrative Complaint, but I wish to be heard at an informal proceeding (pursuant to Section 120.57(2), Florida Statutes) where I may submit testimony and written evidence to the Agency to show that the proposed administrative action is too severe or that the fine should be reduced.
OPTION THREE (3) I dispute the allegations of fact contained in the Notice of Intent
to Impose a Late Fee, the Notice of Intent to Impose a Late Fine, or Administrative Complaint, and I request a formal hearing (pursuant to Subsection 120.57(1), Florida Statutes) before an Administrative Law Judge appointed by the Division of Administrative Hearings.
PLEASE NOTE: Choosing OPTION THREE (3), by itself, is NOT sufficient to obtain a formal hearing. You also must file a written petition in order to obtain a formal hearing before the Division of Administrative Hearings under Section 120.57(1), Florida Statutes. It must be
received by the Agency Clerk at the address above within 21 days of your receipt of this proposed administrative action. The request for formal hearing must conform to the requirements of Rule 28- 106.2015, Florida Administrative Code, which requires that it contain:
Your name, address, and telephone number, and the name, address, and telephone number of your representative or lawyer, if any.
The file number of the proposed action.
A statement of when you received notice of the Agency's proposed action.
A statement of all disputed issues of material fact. If there are none, you must state that there are none.
Mediation under Section 120.573, Florida Statutes, may be available in this matter if the Agency agrees.
License type: (ALF? nursing home? medical equipment? Other type?)
Licensee Name: License number:
Contact person: _
Name Title
Address: Street and number City Zip Code
Telephone No. Fax No. Email(optional). _
I hereby certify that I am duly authorized to submit this Notice of Election of Rights to the Agency for Health Care Administration on behalf of the licensee referred to above.
Signed: Date:
Print Name:·-------------------Title:--------
Late fee/fine/AC
Jan 1701 06:28p 000
p.1
STATE OFF
AGR. CV FOR HEALTH CA
RE: DDJJ LLC d/b/a Briarwood Manor
ORIDA
ADMINISTRATION
ARCA No.: 201100.5869
, •.,,..r4.°:'." lJ
_ AHCA AGl:.NCY CLERK
2011 AUG I 8 p 3: I J . .
This Election of Rjghts fonn is attached to a pro osed action by the Agency for Health Ce.re Administration (AHCA). The title may be Notice r Intent to Impose a Late Fee. Notice of Intent to Impose a Late Fine or Administrative C mplaint.
If you Electio11 of Rights with your selected op on is not received by AHCA within twenty one (21} days from the date you received this notic of proposed action by AHCA, you will have given up your right to contest the Agency's propos acron and a:fillal order will be issued.
(Please use this form unless you, your attorney or y; presentative prefer to reply accordi:ng to
Chapter 120. Florida Statutes {2006) and Rule 28, Fl rida Administrative Code.)
!'
PLEASE RETURN YOUR ELECT ON OF TP THIS ADDRESS:
Agency for Health Care Adminiruation
Attention: Agency Clerk
2727 Mahan Dri Mail Stop #3
Tallahassee, Florida 32308.
Phone: 850-412-3630 Fax: 850-921·0158.
OPTION ONE (1) I admit to the aJlegati ns of racts and law coatained in the Notice
of Intent ro Impose a Late Fi.oc or Fee, or AdmiD trative Cema>lainr and 1 waive my right to object and to have a bearing, I understand that b . giving up my r.i,ght to a hearing, a final order will be issued thatadopts the proposed agEm.cy action d imposes the penalty, fine or action.
OPTIOK TWO (2) _ I admit to the allegati ns of facts contained in 1he Notice ,r Intent to Impose a. Late Fee, the Notiee of Intent t Impose a Late Fine, or Administrative Complaint, bat J wish be heard at an inform proceeding (pursuant to Section 120.57(2), Florida Statutes) where I may submit testimony an written evidence to the Agency to show that
. the proposed adminjstrative tion is too severe or th the fine should be reduced.
OPTION THREE (3} X I dispute the aUegati s of faet ntained in the NotJce of Intent to Impose a Late Fee, the Notice of Intent Impose a Late Fine. or Administrative Complaint, and I req11est a formal hearing (purs t to Subsection 120.57(1). Florida Statutes) before an Administrative Law Judge appointed by th Division of .A.dministnltive Hearings.
PLEASE NOTE: C.hoesi.ng OP1TON THREE ( ), by itself, is NOT sufflelent to obtain a formal hearing. You abo must file a written pef on in order to obtain a fonnal hearing before the Division of Administrative Hearings under Se ti.on 120.57(1), Florida Statutes. It must be
EXHIBIT 3
Jan 17 01 06:28p 000 p,2
received by the Agency Clerk at the address above ith.iJI 21 days of your receipt of this proposed administrative action. The request for formal he · mu.st confoxm to the requirements of Rule 28 106.2015, Florida Administrative Code, which r · that it contain:
Your name, address, and telephone nmnber, an the name, addres and telephone number of
your representative or lawyer, if any.
The file number of the proposed action.
A statement of when you received notice of the gency's proposed action.
A statement of all disputed issues of material fa If there are none, you must state that there
are none,
Mediation Wtder Section 120.573. Florida Statutes, &)' be available in this matter if the Agency
agrees.
License type: A_l_F
(ALF? nursing ho e'?. medical equipment? Other type?)
License number:-----
Contact person: _c:_·.-_:.._f'l_l',. ·
D_o_o_k_f,t_n'-,-i-+-+-----llJ_t'I_N. ,.._
Name Title
Address: S'u .:.t I N 11-' .1>1Tt" S-t
Street and number
l-=tlAl\Y"I ."S l pl iJJ13
City Zip Code
Telephone No. qr;:;-7;5- -t1J1i Fax No. t/J'l ·'ii:f· / _Email(optional). _
[hereby certify that ( am duly authorized to sub.mitt ·s Notice of Election of Rights to the Agency
for Health Care Administration on behalf of the lice ee referred to above.
Si ed: Cu· Date:
Late fee/fine/AC
s ·d
09/22/2011 3:28PM FAX 305919' PHARMC0 litJOOO 1/0008
STATE OF FLORIDA
.. 'L
AGENCY FOR HEAI,TH CARE ADMINISTRATION 1....
RE: DDJJ LLC d/b/a Briarwood Manor·
AHCA No.: 2011009 it-M411ef (J
ere,
ii
'0// S[p l.[: lr1r
. ELECTION OF RIGHTS 22 /::J lt: .,
--···-------------··-------------· -----------·--· ----·-· --·-- <J,
T s Election of Rights form is attached to a proposed action by the Agency for Health -Care Administration (AHCA). The title may be Notlee or Intent to Impose a Late Fee, Notice of lnteJlt to Impose a Late Fine or Admlntstrati\le Complaint.
Tour Election of Rights must be returned by w,il or by (IX within 21 days of the day w receive the attached Notice pf Intent to Impose a Late Fee, Notice of Intent to Impose a Late Fine pr Administrative Comnlajnt.
If )_"our El I with :your selected option Is not · h AHCA within ty _
one you receive 1s no ice o propose ave
given up your right to contest lhe Agency's proposed action and a final order will be issued. ·
(Please use this form unless you, your attorney or your representative prefer to reply according to Chapter 120, Florida Statutes (2006) and Rule 28, Florida Administrative Code.)
PLEASE RETURN YOUR ELECTION OF RIOHTS TO THIS ADPRESS:
Agency for l loalth Caro Administration
Attention: Agency Clerk
2727 Mahan Drive, Mail Stop #3 · Tallahassee,. Florida 32308,
Phone: 850 412-3630 Fax: 85,0-921·0158.
PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS
OPTION ONR (l) _ I aclntH to the alleR9tlon1 of fact1jand law eontulned in the Notice et Intent to Impose a Late Fine or Fee, or Administrative Cof11plaµit and I waive Bly right to object and to have at hearing. I understand that by giving up my right to u hearing, a final order w\11 be Issued that adopts the proposed agency action and imp(>Ke$ the ponalty, fine or action.
OPTION TWO (2) I a"mit to the allegations of facts ontahu.id in the Notice of Intent
1
to Impose a Late Fee, the Notice of Intent to Impose ai Late Fine, or Adminislrative Complaint, but I wish to be heard at an Informal proceedin,11 (pursuant to Section 120.57(2), Floridu Stalutes) where I may submit testimony and written evidence to the Agency to show that the proposed administrative action is too severe or that the fine s}Xould be reduced.
OPTION THREE (3) K I di pute the allegations of fact ntalned in the Notice pf Intent
to: Impose a Late Fee, the Notice of Intent to Impose a: Lat Fine, or Administrative Complaint, and I request a forapal hearing (pursuant to Subsection 120.57(1), Florida. Statutes) before an Administrative Law Judge appointed by the Division of Administrative Hearings.
PLEASE NOTE: Cboosina OPTION THREE (3), by itself;, is NOT sufflelent to obtain 11
formal hearing. You also must file a written petition in order: to oqtain a fonnal hearing before
the Division of Administrative Hearings under Sectioµ 120,51(1), Florida Statutes. It must be
EXHIBIT _.!:L
l'HAHMt;U 0002/0008
rebeived by the Agency Clerk at the uddrcss above within :zt days of your receipt of this proposed
.. a inistrative action. The request for formal hearing must conform to the requirements of Rule 28- 106.2015, Florida Administratlve Code, which reqyires that it contain:
1.. You,r name, address, and telephone nwnber, and the name. address1.and telephone number of yo·ur representative or lawyer, if any. · ·
3.:
i The file number of tho proposed action.
A statement of when you received notice of the Agency's proposed ut--tion.
-- 4.: A s. tatem·-e•n-t--o--f--a·-l-l·d··i-s·p-·u··-t·e··d-· ··i·-s· s··u-·e-s---o--f--·m·· a··te·r·i-a-l- fact. If. there ar-e- none, you must.state that_tbc.ro are none.
M diation under Section 120.573;' Florida Statutes, may be available in this mutter if the.Agency
agrees. ·· ·
License nuriitiiirl-Y'-:7 i
License type: II t..-P (ALF'? nursing home? medical equipment? Other type?)
Co,ntact person:
Address: r-h't I /JW
Street and number
Telephone No. 9SV ...1J J"'
3fP?
D oo µ._f;/2.ltN A-D tJ;r:SrP.14-,t>JZ..
a r 33 's
Name · TiJle
2. rH s l,l'f ..H)e:fl..f,f;t:u.. FL 3.1
City Zip Code
Fax No. °l V :J.J/J ,Rmall(optional). _
'JVJi
for
I hereby certify that T am duly autliorized to submit this Notice of Election of Rights to the Agency
Health Care Administration on behalf of the licensee referred to above.
',
La,te fee/fine/AC
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
AGENCY FOR HEALTH CARE ADMINISTRATION,
Petitioner,
vs.
DDJJ, LLC d/b/a BRIARWOOD MANOR,
Respondent.
)
)
)
)
)
) Case Nos. 11-4432
) 11-5103
)
)
)
)
)
ORDER OF CONSOLIDATION
These cases having come before the undersigned on the Agreed Motion to Consolidate, filed October 14 and 17, 2011, and the undersigned having reviewed the records in these cases, it is, therefore,
ORDERED that:
DOAH Case Nos. 11-4432 and 11-5103 are consolidated pursuant to Florida Administrative Code Rule 28-106.108.
The style of this cause is amended as reflected above.
DONE AND ORDERED this 17th day of October, 2011, in Tallahassee, Leon County, Florida.
ERROL H. POWELL
Administrative Law Judge
Division of Administrative Hearings The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
(850) 488-9675
Fax Filing (850) 921-6847 www.doah.state.fl.us
EXHIBIT 2-_
Filed with the Clerk of the Division of Administrative Hearings this 17th day of October, 2011.
COPIES FURNISHED:
Lourdes A. Naranjo, Esquire
Agency for Health Care Administration 8333 NW 53rd Street, Suite 300
Miami, Florida 33166
Cindy Dookeran Briarwood Manor
5631 Northwest 28th Street Lauderhill, Florida 33313
Cindy Dookeran
DDJJ, LLC d/b/a Briarwood Manor 5621 Northwest 28th Street Lauderhill, Florida 33313
2
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
AGENCY FOR HEALTH CARE ADMINISTRATION,
Petitioner,
vs.
DDJJ, LLC d/b/a BRIARWOOD MANOR,
Respondent.
)
)
)
)
)
) Case Nos. 11-4432
) 11-5103
)
)
)
)
)
ORDER CLOSING FILES AND RELINQUISHING JURISDICTION
These causes having come before the undersigned on Petitioner's Motion to Relinquish Jurisdiction, filed
January 25, 2012, to which Respondent did not file a response, having been provided an opportunity to do so, and the undersigned being fully advised, it is, therefore,
ORDERED that:
The final hearing scheduled for February 27 and 28, 2012, is canceled.
The files of the Division of Administrative Hearings are closed. Jurisdiction is relinquished to the agency.
EXHIBIT f_
DONE AND ORDERED this 6th day of February, 2012, in Tallahassee, Leon County, Florida.
ERROL H. POWELL
Administrative Law Judge
Division of Administrative Hearings The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
(850) 488-9675
Fax Filing (850) 921-6847 www.doah.state.fl.us
Filed with the Clerk of the Division of Administrative Hearings this 6th day of February, 2012.
COPIES FURNISHED:
Lourdes A. Naranjo, Esquire
Agency for Health Care Administration 8333 NW 53rd Street, Suite 300
Miami, Florida 33166
Cindy Dookeran Briarwood Manor
5631 Northwest 28th Street Lauderhill, Florida 33313
2
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,
Petitioner, AHCA NO.: 2011009335:2011005869 CASE NO.: 12-106PH
vs.
DDJJ LLC d/b/a BRIARWOOD MANOR,
Respondent.
I
ORDER CLOSING FILE AND RELINQUISHING JURISDICTION
This cause came before the undersigned upon receipt from the Respondent informing of the withdrawal of the request for a hearing. Based upon this notice from the Respondent informing that the facility is closed the Respondent specifically informs that the Respondent no longer requests a hearing. A copy of this writing from the Respondent is attached hereto as Exhibit 'A' and by reference made a part hereof. The undersigned being fully advised, it is, therefore,
ORDERED that:
1. This informal hearing file is closed and jurisdiction is relinquished to the Agency for Health Care Administration for entry of final order.
DONE AND ORDERED at Tallahassee, Leon County, Florida, this 2nd day of April,
2012.
Agency for Health Care Administration
&,cliarcCJ0o1epli"Jalilia Richard Joseph Saliba Informal Hearing Officer
EXHIBIT 1
Copies furnished to:
Lourdes Naranjo, Esquire
Agency for Health Care Administration (Electronic Mail)
Ms. Cindy Dookeran
DDJJ LLC d/b/a BRIARWOOD MANOR
5621 NW 28th Street Lauderdale Hill Fl 33313
2
5621N.W. 28th St. L.:iudcrhill Fl. 33313
Phone: 954--735-8989 Fax: 954-48S-3641
Reference to case#: -106PH. AHCA Nos. 20110056869 & 2011009335.
Formerly DOAH Nos. -4432 & 11-5103.
ATTN: Mr. Saliba
This letter is to inf rm you that Briarwood Manor was officially closed anq is no longer in operatio as of 3/21/12. Briarwood Manor is no longer interested in defending this case.
Thank you
{J/t, 1,
Cindy Dookeran
| Issue Date | Document | Summary |
|---|---|---|
| Jun. 25, 2012 | Agency Final Order |
