STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE poe ADMINIS TRATION retention a Petitioner, vs, Case No: 2011006319: INFINITY HOME CARE .OF PORT CHARLOTTE, LLC, Respondent: 120,57, Florida Statutes Q01 2 The Agency has jurisdiction. over the Resporidérit-pursvant to Sections 20.42. and 120.60, Florida Statutes (2011); Chapters-408, Part Hl, and 400, Part IIL, Florida Statutes (2014), Filed May 30, 2012 3:51 PM Division of Administrative Hearings and Chapter 59A-8, Florida Administrative Code, 3. Venue lies pursuant to Rule 28-106.207, Florida Administrative Code. PARTIES Easeritere fucose eee ann na 4, The: Ageney is the licensing and regulatory: antloeiy ¢ shat oversées horne health agencies and enforces the applicable federal and state statutes, regulations and rules: governing: Pursuant to Florida law, a registered nurse: shall be curt 4, Florida Statutes ¢ 26th nutsing and therapy cate, Becres ponsible for the clinics 11), and-be ‘the. ¢ “receiving nursing cate; iand assure that progress reports are.made°to the: physician for patients receiving mirsing services when the patient’s condition changes:or there.are:deviations from: the nanan possibly leading to-a‘negative-outcomer plan of care. Rule 59A-8.0095(3)(a), Florida Administrative Code. 8. On.or about May 19; 2011, the Agency: conducted a Complaint Survey (CCRH. 20110 1053.11) of th of the 1c Respondent’s facility. inh grerenicnte et mpeoenignmariiumenivwientinteni imorrmnoenttemetintindeiet i 9. Based on medical record review and interview, the home health agency failed toe ensure there was ongoing assessments atid interventions in place to meet'the changing needs for one (1) of three (3) patients reviewed, specifically Patient number two (2). 10, The tiedical record review revealed Patient number two (2)'developed addi skin wounds: Left Hip Febtuaty-21, 2011, Upper: Left Arm February 28, 2011, Left Ankle” Right Upper Arm March 7, 2011, New Tear noted on March 11, 2011, and Bilateral Knees. 12; An interview with the Director of Nursing and a telephone ‘interview was: conducted with the nurse. who. provided.the skill service on May 19; 2011 at:4:25-pam., it was stated the. physician was not. notified. of additional skin tears. The Director of Nursing.and the nurse confirmed the physician was not notified of new skit teats. 13. The nurse who provided. the skilled service came into the office and the interview ieee COntiEd at 5:05 pan, The nurse Stated.on, March 29, 2011 th 2011. the-skin was off and it be t becatne an. a open wound so.it was.@ Stage IN. She'stated, "Icalled the doctors nurse for a Foley catheter and. air mattress for a non-healing Stage HL pressure area, The nutse stated the other order. for the Foley catheter: was placed on March: 29;:2011, The tiutse colitinued ‘to. state, "Tindertéd it off April 1, 2011, my next visit" The nutse could ‘not explain why she left now open wound exposed:to utine and feces for ‘three (3) days, The ‘home health agency. was not able to provide _ evidence the Stage TIL pressure sore was adsessed for drainage, odor, pain, reditess, nox was thé evidence of the wourid's mensuromicnt: hysiclan and other personnel of changes 14. The facility failed to infos ‘ih the patient's condition and needs. The fa ‘with the ‘physician related to-assesstient, and't placement, 18: Section 400.484(2)(b), Florida aeuincgune, 16. Upon finding a Class II defictenoy, the Agency shall impose an administrative. fine in the: amount of five-thousand dollars (65,0 pisuant to Section 400:484(2)(b), Florida Statutes (2011). sctionr date-of June-19;-20 1a “The Respondent was given amandator WHEREFORE, the Petitioner, State of Florida, Agency for'Health Care Administration: intends to impose an administrative fine against the Respondent jn the amount of FIVE THOUSAND DOLLARS ($5,000.00) pursuant: to Section, 400.484(2)(b), Flotida ‘Statutes (2011). The Respondent Failed To Implement Treat Viclitlon Of Section 400,487(2), Florida § ; smote ool OM aA Canin Sth 18 The Agency re-alleges and incorporates by shamans (1) through five (5). 19. Pursuant to Florida law, when required by the provisions of Chapter 464; Part I, Part ia or Patt Voof Chapter 468; or Chapter 486, Florida Statutes ea a the: ste spas’ ‘Scope: Ofpractice, shall establish. treatment orders fora ‘patient ‘who is to recelye skilled dare. The. ireatment orders ust be signed by the: physician, physician assistant, ox d services! is. dated withthe date of receipt by the nurse or therapist who talked with the physician, physician: assistant, ot advanced registered nurse ptactitioner’s office. Rule 59A-8,0215(2), Florida Administrative Code, 20. Qn-or about May 19, 2011, the Agency’ conducted a Complaint Surves ~A0LLO0S31.1)-0F the Respond ént’s facility. nsetsnicenintaihernaetii indented 21. Based on medical record. review and inteiview, the‘home health agen the writtén plan of care, specifically Patient nuitiber two (2) and Patient number thiée home health.agency failed to follow physician's orders for treatments, failed to-assensw with each: visit and failed to-obtain additional wound care orders. These failures ‘cant ‘pive:tise to adversely aff paticiit's expected viitcome, nit number two(2) had. a stat of care dated Febru us ulgers, heel and lower back-as a Stage Tl, Alzheime's disease ificdtion and Plan of Care dtdets were Lor skill “one (1) weeks; three (3) ‘visits for two nd treatment order was'to; "Assess Wot ive (5) days:as needed until healed," al.sécord review revealed Patient number two (2) dey March 15, 201 }.There isnorevidence:in the medical record of the physician being notified ofthe: patient's. changing condition. The liome health.agenoy was-not able to provide evideticé of case conferences régarding the patient's changing status. The wound measutements were: fot 6 performed weekly. The medical record did not provide evidence of wound assessments: for drainage, odor, pain, and redness for each visit.as otdeted.. ae 24? Dating Ai MIG Ee DiRT SE NURIEE OH DY TOQOTT "aes a the Director of Nursing stated it is the facility's practice to do wourd riensuieiiént weekly: Thore is no written policy. The Director of Nuising and the surveyors wont through the: nuisinig notes-and determined the wound was assessed'and desoribed at the Start of Care‘on February 19, . 2011, on March. 18,2011 and. Maroh.21; 2011, The Director: of Nursilig-confitmmed ‘the: wound was not-measured aifid assessed weekly. taking it difficult to determine the statis of the wound and possibly leaditig'to 4 negative outcome, 25. An interview with the D ‘became .an oper wound so it was:a Stag Foley catheter atid air matiress for ranonehe i changes with thes wo! A review of Patient, number three’s (3) medical record revealed the current: progression. 27, ‘physician order dated April°7, 201] noted'a. wound vac (an. electronic. device to promote wound healing) to be set at150 mm/Hg. with: intermittent suction, A review of the nursing Hotes dated. | ne “] “Motida StatiitesQ0t1).— - April 9, 2011 and April 16, 2011 documented the wound vac was set at 125 imni/Hg’ with dotemiittent suction, Be mrnnnminntren func Utng.2n..dnterview...with the, .Director..of Nutsing..on.May.19 19,201 Jn fh aftemoon:she confirmed the nurse did not-follow:the ‘physician's order, 29. A teview of a physician order for Patient number three (3) dated: April: 19, 2011 documented foam to be applied to "Testia:" The order does not say how often this is 'to-be dong; ‘Tho nursedid not elarify the order and‘on- April 21, 2011 the tiutsing ote: documented foam was applied:to the:scrotum. A yeview of the nursing note dated April 23; 2011 does not document any treatment was: applied to the scrotum, The nursing note dated April 28, 2011 documented the sorotum was-washed ‘with saline-and Mepilex was an apsliegs ‘The nursing note:dated May 3 3, 2001 ~——_~$; —‘The-Respondent’s-act; omission; or pract health, safely, or’ security of a patient and: constituted a: 33. ‘The Respondent -was-given.a mandatory cotrection date of June 19, 2011, WHEREFORE, the Petitioner, State of Florida, Ageticy for Health Cate Administration intends to impose. an adiiilnistrative. fitte against the Respondent in the amount of TEN THOUSAND DOLLARS ($10,000.00) pursuant to Section 400.484(2)(a), Florida. Stanites’ (2011). WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, respéctfilly requests:thé Court to enter a-final ordet granting thé followingeeliet against ‘the Respondent: 1. Make findings of fact and'conclusions of law in favor of the Agency. 2, dnninisteative fine against the Respondent in the amount of FN THOUSAND DOLLAR 3 Eni NOTICE” Cantu Court, Suite 116, Sarasota, Florida 34232; Home Care of Port Chatlotte, LLC, o, 7003 3110:0001 0449 9895, and to: Cheryl | United States: Certified Mail, Retuii Reseipt } ‘Meyer, Administrator, Tahinily” “Poit Chailétig) LLC) 4161 Tamianit Tiail, Suite ~~ 904, Port Charlotte, Florida 39952, United States Certified Mail, Retirn Reveipt No. 7003 3110 000104499888 onthis Sets day of__ fee bo 2012. e, Room 346C Fott Myers, Flo 33901 Telephone: (239) 335-1253 10 Copies furnished to: ; Cheryl J. Meyer. Administrafor STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARB ADMINISTRATION, maomoncnnnnitelanumaniveeanaicetnesternelirontsetsniavimerta teh ehtiaiwartense iomatenrnceecesteciutieuaantihatntie Petitioner, vs. ; Case'No: 2011006319: INFINITY HOME CARE OF PORT CHARLOTTE, LLC; Respondent, " a Late Fine or Fee, of veahearing. Toinderstan 2 wi i be j issue: that adopts the proposed agency action and imposes the penalty, fine or action, OPTION: TWO (2) ___ I adiniit-the allegations of fact: and Jaw contained in the Notice of Intent to Inipose-a Late Fine or Feo; or Administrative Complaint, but I wish:té:be heard at an informal proceeding (pursuant to Section: 120, 51(2); Florida Statutes): where: L may testimony and written evidence to the Agency to show that the proposed admi i too severe or that the fine should be reduced. OPTION’ IREE. (3). [dispute the alle a Late Heed the Noti ITE: Choosing OPTION THRE: (3) by i Youalso must file a written. p c Print Name: Title: Sari pA RRS re ne ese ae eke ee ee seem Hee NADA ye COMPLETE THIS SECTION ON DELIVERY TE THIS SECTION

Docket for Case No: 12-001957

Orders for Case No: 12-001957