STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE. OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA No.: 2012000595 Return Receipt Requested: v. 7009 0080 0000 0586 7520 BCJ RETIREMENT HOME, INC. d/b/a BCI RETIREMENT HOME, INC., Respondent. 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 BCJ Retirement Home, Inc. d/b/a BCJ Retirement Home, Inc. (hereinafter “BCJ Retirement Home, Inc.”), pursuant to Chapter 429, Part I, and Section 120.60, Florida Statutes (2011), and alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine of $1,000.00 pursuant to Sections 429.14 and 429.19, Florida Statutes (2011), for the protection of public health, safety and welfare. Filed May 2, 2012 1:46 PM Division of Administrative Hearings JURISDICTION AND VENUE 2. This Court has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes (2011), and Chapter 28-106, Florida Administrative Code (2011). 3. Venue lies pursuant to Rule 28-106.207, Florida Administrative Code (2011). PARTIES 4, 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 (2011), and Chapter 58A-5 Florida Administrative Code (2011). 5. BCJ Retirement Home, Inc. operates a 5-bed assisted living facility located at 4976 S. W. 7 Street, Margate, Florida 33068. BCJ Retirement Home, Inc. is licensed as an assisted living facility under license number 10781. BCJ Retirement Home, Inc. 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 BCJ RETIREMENT HOME, INC. FAILED TO ENSURE A LICENSED NURSE PROVIDED MEDICATION ADMINISTRATION. SECTION 429.256 (1)&(4), FLORIDA STATUTES RULE 58A-5.0185(3), FLORIDA ADMINISTRATIVE CODE (ASSISTANCE WITH SELF-ADMINISTRATION OF MEDICATION STANDARDS) CLASS II VIOLATION 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. BCJ Retirement Home, Inc. was cited with one (1) Class II deficiency as a result of a monitoring survey that was conducted on December 8, 2011. 8. A monitoring survey was conducted on December 8, 2011. Based on observation of medication administration, interviews with staff and resident's physician, and review of resident records, it was determined the Assisted Living Facility failed to ensure a licensed nurse provided medication administration for 4 of 5 sampled residents (#1, #2, #3, #4). The findings include the following. 9. On 12/8/2011 at approximately 9:30 AM a tour of the ALF was conducted. Resident #1 was observed in her room and a Hospice nurse was attending to her. The nurse indicated the resident was totally dependent for all activities of daily living, minimally responsive, and had a large stage coccyx wound. 10. Resident. #2 was noted seated in a wheel chair receiving a nebulizer treatment (medication by inhalation route). The ALF's CNA was observed standing next to the resident and stated "She gets one every day and I give it to her mostly." The CNA stated she also gives resident #3 her daily nebulizer treatments. 11. Resident's #3 and #4 were noted seated on the couch in the living room asleep. 12. A review of resident #1's Health Assessment (AHCA 1823) dated 11/21/2011 revealed the hospice resident was totally dependent with all activities of daily living (ADLs) and "needs medication administration." A review of her Medication Observation Records (MORs) revealed the unlicensed ALF staff was administering the medications. 13. A review of the December 2011 MORs for resident #2 revealed Albuterol sulfate Solution 0.083% 1 vial per day as needed (PRN), but all of the days were initialed off as provided by unlicensed ALF staff. 14. A review of resident #3's MORs from November to December 2011 revealed Nebulizer treatment Albuterol Sulfate solution 0.083% 1 vial twice daily as needed. All of the days were initialed as provided by unlicensed ALF staff. 15. A review of resident #4's December 2011 MOR revealed an order for Ativan 1 milligram take one tablet once daily as needed. The November and December MORs revealed the Ativan was provided every day by unlicensed ALF staff. 16. An interview was conducted at 10:30 AM with the Administrator and CNA, both indicated they had taken the medication courses but both denied knowledge of the prohibition against unlicensed staff providing nebulizer treatments, as needed (prn) medications, and administering medications. The CNA and Administrator stated they had been operating in the manner for "years." 17. At 10:45 AM a phone interview was conducted with the resident's physician he stated he was aware residents #1 and #3 were receiving nebulizer treatments and that resident #4 was receiving prn Ativan. He also confirmed his notation on the AHCA 1823, for resident #1 as correct and that she required "full administration of medications." 18. The physician stated he was not aware unlicensed ALF staff could not provide these services and "I rely on the Administrator to let me know the limitations of her licensed home." 19. Section 429.256(4), Florida Statutes provides that “assistance with self-administration does not include: ... (c) administration of medications through intermittent positive pressure breathing machines or a nebulizer, ... (h) medications ordered by the physician or health care professional with prescriptive authority to be given “as needed”...” 20. Based on the foregoing facts, BCU Retirement Home, Inc. violated Section 429.256(1)&(4), Florida Statues, and Rule 58A-5.0185(3), Florida Administrative Code, herein classified as a Class II violation, which warrants an assessed fine of $1,000.00. CLAIM FOR RELIEF WHEREFORE, the Agency requests the Court to order the following relief: 1. Enter a judgment in favor of the Agency for Health Care Administration against BCJ Retirement Home, Inc. on Count I. 2. Assess an administrative fine of $1,000.00 against BCJ Retirement Home, Inc. on Count I for the violation cited above. 3. Assess costs related to the investigation and prosecution of this matter, if the Court finds costs applicable. 4, 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 (2011). 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 Bre cos G herrnes fe Lourdes A. Naranjo, Esq. Fla. Bar No.: 997315 Assistant General Counsel Agency for Health Care Administration 8333 N.W. 53°? 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 Barbara Wilson, Administrator, BCT Retirement Home, Inc., 4976 S. W. 7 Street, Margate, Florida 33068 on this GE,., of Lal , 2012. J ng f 2D Channon, ae A. Naranjo, Esq. - USPS.com® - Track & Confirm * saa a Page 1 of 1 * English Gustomer Service USPS Mobile Register? Sign In . BaZUSPS COM Search USPS.com or Track Packages Quick Tools. Ship a Package Send Mait Manage Your Mail Shop Business Solutions Track & Confirm YOUR LABEL NUMBER SERVICE STATUS OF YOUR ITEM DATE & TIME LOCATION FEATURES: | 70090080000008867520 : Delivered April 11, 2012, 11:03 am | POMPANO Cerfiffed Mail™ i | BEAGH, Fl, 33068 Arrival at Unit April 11, 2042, 8:16 am + POMPANO. | BEACH, FL 33068 Check on Another Item What's your labet (or recelpt) number? LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES. 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Docket for Case No: 12-001586

Orders for Case No: 12-001586