STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

V. AHCA NO. 2012001199

RENDITION NO.: AHCA-12- l)IJ 12- -5-0LC

SA PG LARGO, LLC d/b/a PALM GARDENS OF LARGO,

Respondent.

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FINAL ORDER

Having reviewed the Administrative Complaint, and all other matters of record, the Agency for Health Care Administration finds and concludes as follows:

1. 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.

   
   

2. The Agency issued the attached Administrative Complaint and Election of Rights form to the Respondent. (Ex. 1) The Election of Rights form advised of the right to an administrative hearing.

   
   

3. The parties have since entered into the attached Settlement Agreement. (Ex. 2) Based upon the foregoing, it is ORDERED:

I. The Settlement Agreement is adopted and incorporated by reference into this Final Order. The parties shall comply with the terms of the Settlement Agreement.

1. The Respondent shall pay the Agency $1,875.00 in administrative fines. 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:

   
   

   Office of Finance and Accounting Revenue Management Unit

   Agency for Health Care Administration 2727 Mahan Drive, MS 14

   Tallahassee, Florida 32308

   
   

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   Filed August 10, 2012 12:59 PM Division of Administrative Hearings

2. Conditional licensure status is imposed on the Respondent beginning on January 9, 2012, and ending on January 25, 2012.

ORDERED at Tallahassee, Florida, on this _J    day of _,   ,, "'-'--_,.I "'-'-,,_--_-                                                     ,2012.

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Eliza

Age ea inistration

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 correcJs,Qpy of this Final rder was served on the below-named

persons by the method designated on this . day of    -L-.L..:::..>, ----+ ' 2012.

Richard Shoop, Agency Clerk

Agency for Health Care Administration 2727 Mahan Drive, Bldg. #3, Mail Stop #3

Tallahassee, Florida 32308-5403

Telephone: (850) 412-3630

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Docket for Case No: 12-001795

Orders for Case No: 12-001795