Elawyers Elawyers
Ohio| Change

AGENCY FOR HEALTH CARE ADMINISTRATION vs FLORIDA HEALTHCARE MANAGEMENT, LLLP, D/B/A OCOEE HEALTH CARE CENTER, 12-002247 (2012)

Court: Division of Administrative Hearings, Florida Number: 12-002247 Visitors: 17
Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: FLORIDA HEALTHCARE MANAGEMENT, LLLP, D/B/A OCOEE HEALTH CARE CENTER
Judges: LYNNE A. QUIMBY-PENNOCK
Agency: Agency for Health Care Administration
Locations: Orlando, Florida
Filed: Jun. 25, 2012
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Thursday, July 5, 2012.

Latest Update: Sep. 10, 2012
12002247_375_06252012_01435774_e



\


Chapters 400, Part II, and 408, Part II, Florida Statutes, and Chapter 59A-4, Florida


Administrative Code.


1

  1. Respondent operates a one hundred twenty (120) bed nursing home, located at 1556

    l Maguire Road, Ocoee, Florida 34761 and is licensed as a skilled nursing facility license number 13870961.

  2. Respondent was at all times material hereto, a licensed nursing facility under the licensing authority of the Agency, and was required to comply with all applicable rules, and statutes.

    COUNTI

  3. The Agency re-alleges and incorporates paragraphs one(1) through five (5), as if fully set forth herein.

7. That pursuant to Florida law, .all licensees of nursing homes facilities shall adopt and

make public a statement of the rights and responsibilities of the residents of such facilities and shall treat such residents in accordance with the provisions of that statement. The statement shall assure each resident the right to receive adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative services consistent with the resident care plan, with established and recognized practice standards within the community, and with rules as adopted by the agency. § 400.022(1)(1), Fla. Stat.(2011).

  1. That Florida law provides the following: "'Practice of practical nursing' means the performance of selected. acts, including the administration of treatments and medications, in the care of the ill, injured, or infirm and the promotion of wellness, maintenance of health, and prevention of illness of others under the direction of a registered nurse, a licensed physician, a licensed osteopathic physician, a licensed podiatric physician, or a licensed dentist. A practical

    nurse is responsible and accountable for making decisions that are based upon the individual's


    )

    \

    I


    educational preparation and experience in nursing." § 464.003(19), Fla Stat. (2011).


  2. That Florida law provides the following: "A complete, comprehensive, accurate and reproducible assessment of each resident's functional capacity which is standardized in the facility, and is completed within 14 days of the resident's admission to the facility and ever.y twelve months, thereafter. The assessment shall be: 1. Reviewed no less than once every 3 months, 2. Reviewed promptly after a significant change in the resident's physical or mental condition, 3. Revised as appropriate to assure the continued accuracy of the assessment." Rule 59A-4.109(1)(c), Florida Administrative Code.

  3. That Florida law provides the following: "Every licensed facility shall comply with all applicable standards and rules of the agency and shall . .. Maintain the facility premises and equipment and conduct its operations in a safe and sanitary manner." § 400.141(1)(h), Fla. Stat. (2011).

  4. That Florida law provides the following: "The facility shall provide a safe, clean, comfortable, and homelike environment, which allows the resident to use his or her personal belongings to the extent possible." Rule 59A-4.122(1), Florida Administrative Code.

  5. That on February 10, 2012, the Agency completed a recertification survey of the Respondent facility.

  6. That based upon the review of records, observation, and interview, Respondent failed to


    ensure the provision of adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and

    . therapeutic and rehabilitative services consistent with the resident care plan, with established and recognized practice standards within the community and or failed to ensure the facility was maintained in a safe manner related to pain management, infection control procedures, wound care, and the provision of prescribed care and services., the same being contrary to the mandates

    oflaw.


    \

    I



  7. That Petitioner's representative briefly interviewed resident number one hundred forty­ nine (149) on February 8, 2012, at 2:30 p.m. and the. resident indicated that the resident was.in lot of pain in the lower extremities, was not feeling well, and further stated the medication they were providing was not effective.

  8. That Petitioner's representative reviewed Respondent's records related to resident number one hundred forty-nine (149) during the survey and noted as follows:

    1. The resident was admitted to the facility on December 20, 2011, status post fractured right femur, supra pubic catheter, dementia, osteoporosis, history of . muscle weakness, history of multiple sclerosis, hypertension, diabetes, and hyperlipidemia.

    2. The resident was readmitted back to the facility on February 6, 2012, with methicillin resistant staphylococcus infection (MRSA) in the . nares and· vancomycin resistant enterococcus (VRE) infection in the stools.

    3. The,e was,an order to refer the resident to Vohra wound team for an open area to the right ankle.

    4. Physician's order required the cleaning of the right medial ankle (malleolus) with normal saline, or wound cleanser, apply skin barrier to surrounding skin, apply thick layer of santyI ointment and cover with polymem foam dressing and secure with mefix tape once a day.

    5. An admission assessment dated February 6, 2012, assessed the resident as alert and oriented, able to make needs known, and requires extensive assistance with activities of daily living (ADLs).

    6. A nursing admission assessment dated February 6, 2012, at 7:18 p.m. indicated the resident did not verbalize pain.

    7. The resident's medication administration record (MAR) revealed that the resident


      was given a pain medication at 2:47 p.m. on February 8, 2012, and it was effective.

    8. Nurses' progress notes did not document that the resident has complained of pain, nor was the resident assessed with the severity and location of the pain.

    9. The records do not reflect that the resident's physician was informed of the severe pain in the right lower extremity.

    10. The resident's medication administration record (MAR) on February 9, 2012, reflected orders for Percocet 51?25 milligrams (mg.) administer 10/650 mg. every 4 hours for severe pain.

    11. The last time the resident received the pain medication was on February 8, 2012, at 10:22 p.m.

      1. It was documented the medication was given for pain and was marked as effective.

        1. There was no documentation in the nurses' notes regarding the location and the intensity of the pain related to this medication administration.

        2. The minimum data set (MDS) assessment, dated February 6, 2012, on the pain


          -interview conducted by the MDS staff, reflects the resident had verbalized frequent pain in the last five (5) days and had difficulty sleeping related to the pain. The pain was assessed on a scale of 1-10 as a 9 and was described as severe.

        3. Care plans dated January 2, 2012, revealed the resident was at risk for pain related to ulcers on the heels and ankle and a recent right distal femur fracture.

        p, Care -plan interventions were to: monitor and record any complaints of pain, location and intensity; and offer use of pain medication prior to care tasks,

        treatments, and therapy,


        \

        /


  9. That Petitioner's representative observed wound care by Respondent's staff nurse to resident number one hundred forty-nine (149) on February 9, 2012, at 11:15 a.m. and noted as follows:

    1. The nurse gathered his equipment; a stack of 4 x 4 unsterile gauze, polymen tape, normal saline, and santyl ointment and placed this on top of the bedside table without any barrier.

    2. He proceeded to remove the soiled dressing and disposed it in the red trash bin inside the room.

    3. He started to cleanse the wound with normal saline, attempting to remove the


      cream colored slough on the wound bed and the resident grimaced in pain, grabbing into the bed sheets and verbalized pain when asked by this surveyor.

    4. The resident demonstrated signs of extreme pain and verbally complained of the pain in the right leg and the wound.

    5. The nurse validated that he had not given the resident pain medication prior to the dressing procedure and indicated he offered the medication earlier and the resident had declined.

    6. The surveyor asked the nurse to stop the procedure and he did.


    7. The nurse left the room to obtain the pain medication and returned and gave it to the resident.

    8. The nurse did not assess the pain of the resident and did not ask the resident the scale level/severity of the pain (e.g. location and intensity of the pain).

  10. That Petitioner's representative interviewed resident number one hundred forty-nine


    (149) on February 9, 2012, at 2:00 p.m. and the resident indicated that during the wound care procedure earlier that day, the pain was at a JO on a scale of 1-10.

  11. That Petitioner's representative interviewed Respondent's unit coordinator and reviewed


    \

    J


    Respondent's records related to resident nwnber sixty-eight (68) during the survey and noted that the resident was admitted to the Respondent facility with an intact deep tissue injury (DTI) of the right heel.

  12. That Petitioner's representative observed wound care to resident nwnber sixty-eight (68)


    on February 9, 2012 at 10:30 a.m. and noted as follows:


    1. The wound care treatment and dressing change was for the resident's right heel pressure ulcer.

    2. The resident was fidgety and restless with verbal confusion.


    3. When the nurse applied medication into the wound bed With a Q-tip, the resident exhibited non-verbal facial signs of pain by squeezing the eyes shut at least three times.

    4. The facial grimacing stopped after the treatment ended.


    5. The resident did not yell or cry out during the treatment.


    6. The pressure ulcer measured about 1 centimeter (cm) in length, about 1 cm in


      i

      I width, and 1/2 in depth.

      !

      I

  13. That Petitioner's representative reviewed Respondent's records related to resident


    nwnber sixty-eight (68) during the survey and noted as follows:


    .a. The February medication administration (MAR) revealed that the nurse had not given the resident pain medication prior to the pressure ulcer treatment.

    . b. The MAR did not reflect that the resident had an order for pain medication to be given prior to her right heel treatment and dressing change.

    1. Wound care physician's progress note dated February 7, 2012, docwnented that the physician had surgically debrided and opened the right heel pressure ulcer on February 7, 2012.

    2. The physician described the pressure ulcer as deteriorated, unstageable necrosis



      )

      \

      I


      with 40% necrotic tissue, and moderate serous drainage. The measurements after the debridement were documented as 1cm x 1cm x 0.5 cm.

    3. After the debridement, the physician changed the treatment orders to include the application of the medication, Iodosorb, with a Q-tip into the center of the wound bed and cover with a Mepilix dressing daily and as needed until healed.

    4. The resident's admission nursing assessment dated August 4, 2011, included a pain assessment which revealed that the resident did not have pain.

    5. Monthly nursing assessments from September 2011 through January 2012 also revealed that the resident did not have any pain.

    6. The resident was assessed to have memory problems and was confused.


    7. Diagnoses included dementia and anxiety.


    8. The resident's pain management needs had not been reassessed after the wound debridement and order of Q-tip use to apply medication to the wound b\ld which increased the risk of pain during treatments.

    9. The medical record reflected that the resident was confused and was not a


    candidate for being able to verbalize pain levels.


  14. That Petitioner's representative interviewed Respondent's unit coordinator on February 9, 2012 at about 11:30 a.m. related to resident number sixty-eight (68) and the coordinator indicated as follows:

    1. He validated that the resident's pain ne ds had not been reassessed after the debridement and new orders.

    2. He validated that a pain medication order had not been obtained prior to wound


      treatment.

    3. He validated that the pressure ulcer treatment prior to debridement did not involve a Q-tip to apply the medication to the wound bed, but the new treatment after the


      )


      debridement did.

    4. The change from applying the medication into the wound bed with gauze to a tip could have made the difference in the resident's increased pain observation during treatments.

  15. That Petitioner's representative interviewed Respondent's nurse who treated resident number sixty-eight (68) during the survey who indicated that she noticed the resident squeezing the eyes shut while applying the medication to the wound bed, but thought it would be· okay to continue.

  16. That Petitioner's representative interviewed Respondent's director of nurses related to resident number sixty-eight (68) during the survey who indicated that nurses were to assess for pain levels; verbal and non-verbal, and if a resident was confused and couldn't verbalize pain levels then, body/face signs were to be assessed.

  17. That Petitioner's representative observed wound care by Respondent's staff nurse for resident number one hundred forty-nine (149) on February 9, 2012, at 11:15 a.m. and noted as follows:

    1. The nurse gathered his equipment; a stack of 4 .x 4 unsterile gauze, polymen tape, normal saline, and santyl ointment and placed this on top of the bedside table without any barrier.

    2. He proceeded to remove the old dressing and disposed it in the red trash bin.


    3. The resident was on contact isolation precautions for methicillin resistant staphylococcus aureus (MRSA) infection to the nares and vancomycin resistant enterococcus (VRE).

    4. The wound had a small serous discharge.


    5. The wound bed was covered with eschar with cream color slough.


    6. The edges were pinkish and irregular.


      )


    7. The periwound was pinkish/slightly swollen and there was no odor noted.

      · h. The nurse started to cleanse the wound with normal saline, while attempting to remove the slough on the wound bed, and placed the soiled/used gauze dressings on top of the stack of clean gauze.

      1. He discarded the soiled dressing that was placed on top.of the clean gauze in the red trash bin for contact isolation.

      2. The nurse did not have a red bag or plastic bag specific for the soiled dressings for

        · wound care procedure.


      3. He used the remaining gauze to apply the santyl ointment, covered it with polymem dressing and mepix tape.

  18. That Petitioner's representative interviewed Respondent's nurse who had performed wound care on resident number one hundred forty-nine (149) on February 9, 2012 and the nurse indicated as follows:

    1. He validated that he failed to apply a barrier on the bedside table prior to placing all clean equipment for dressing change.

    2. He placed soiled dressings on top of the clean gauze,.and used the contaminated gauze to apply the santyl ointment to the wound,

  19. That Petitioner's representative reviewed Respondent's records related to resident number one hundred forty-nine (149) during the survey and noted as follows;

    a, The admission assessment reflected the resident's skin assessment was not conducted correctly as the assessing nurse documented on the skin integrity sheet that the resident had a surgical wound and red blanchable area and no foot problems,

    b, Admitting diagnoses from the hospital revealed a pressure ulcer on the right ankle

    (stage 2) and a deep tissue injury (DTI) unstageable, on the right heel.


    )

    \

    I


    1. Admission orders indicated to refer resident to a wound care specialist.


    2. The assessing nurse did not complete a thorough and accurate skin assessment to reflect the skin condition of the resident based upon the resident's condition and hospital records.

    3. Nurses' progress notes dated February 9, 2012, at 12:30 a.m. documented that


      while applying skin prep to the deep tissue injury on the right heel, other areas of skin impairment were noticed: A stage 2 to the back of the right ankle (6 centimeter (cm.) x I cm.) and a stage 2 to the back of the right shin (7 cm. x 5 · cm.). Also, there were 2 scabs approximately 1.5 cm. x I cm.

    4. Documentation of February 9, 2012, at II :45 a.m. reflects the physician was notified that upon reexamination of wounds there were 2 stage 2 wounds and 2 unstageable wounds.

  20. That Petitioner's representative interviewed Respondent's unit coordinator and reviewed Respondent's records related to resident number sixty-eight (68) during the survey and noted that the resident was admitted to the Respondent facility with an intact deep tissue injury (DTI) of the right heel.

  21. That Petitioner's representative observed wound care to the right heel pressure ulcer of resident number sixty-eight (68) on February 9, 2012 at 10:30 a.m. and noted as follows:

    1. When the nurse and certified nursing assistant (CNA) removed the resident's right sock and leg geri-sleeve, there was no dressing covering the open right heel pressure ulcer.

    2. The resident's nurse performing the wound care and the certified nursing assistant assisting the nurse verified this finding.

    3. The nurse stated that a dressing had been ordered to cover the pressure ulcer.


    4. The pressure ulcer measured about 1 centimeter (cm) in length, about 1 cm in

      JI


      ) )


      width, and 1/2 cm in depth.


    5. When asked about the missing dressing, both stated that they did not know why the resident's pressure ulcer dressing was not on the heel.

    6. At this time, the certified nursing assistant stated that she had not gotten the resident up and dressed that day, so she had not noticed that the dressing was missing.

    7. She stated that the 11-7 certified nursing assistant had gotten the resident up and dressed.

    8. .When upon request to see the resident's left heel condition, r.emoval of the resident's left sock and leg geri-sleeve revealed that a crumpled up dressing was inside the left foot sock.

  22. That Petitioner's representative reviewed Respondent's records related to resident


    number sixty-eight (68) during the survey and noted as follows:


    1. Right heel treatment orders dated February 8, 2012, included that the pressure ulcer needed to be covered with a dressing as follows: "...clean with normal saline or wound cleanser, pat dry with 4"x 4" (gauze) dressing, apply skin prep around the peri-wound, apply Iodosorb with a Q-tip to the center of wound bed, cover with a Mepilix dressing, change every day, and as needed until healed."

    2. The facility scheduled the dressing change on the 7:00 a.m. - 3:00 p.m. nursing shift,

    3. The wound care physician's progress note dated February 7, 2012, for the resident revealed the physician had surgically debrided and opened the right heel pressure ulcer on February 7, 2012.

    4. The physician had ordered the above new treatment orders at that time.


  23. That Petitioner's representative observed service of the lunch meal in the assistive dining


    room on February 7, 2012, commencing at 12:15 p.m., and noted as follows:


    j a. A certified nursing assistant was feeding two (2) residents at the same time, residents numbered seventeen (17) and forty-eight (48).

    b. The certified nursing assistant was observed wiping the mouth ofresident number forty-eight (48) and then returning to feed resident number seventeen (17) without washing hands in between direct resident contact.

  24. That Petitioner's representative observed medication pass on the 600 wing on February?,· 2012, commencing and noted at 9:45 a.m., while staff administered medications to resident number twenty-seven (27), the following:

    1. The nurse was observed touching the medication with her hands.


    2. She dropped a pill, Calcium 600 mg. ·1 tablet, on the cart.


    3. She took it with her hands and placed it inside the medication (med) cup.


    4. She· was also .observed touching the medication with her bare hands, Phenobarbital 30 mg. I tablet, after she obtained it from the packet and placed it in the med cup and gave these medications to the resident.

    5. She dropped a pill on the floor, picked up.the medication from the floor and discarded it.

    6. She then went back to the cart and obtained a new pill without washing her hands.


· 32. That Petitioner's representative interviewed the above referenced medication nurse immediately thereafter and she validated the observations.

  1. That Petitioner's representative observed Respondent's nursed conducting an accu-check


    on resident number one hundred sixty-seven (167) on February 9, 2012; at 12:10 p.m. and noted that the glucometer machine had dried, old blood on it and the nurse did not clean the machine prior to using it on the resident.

  2. That Petitioner's representative interviewed the above referenced nurse immediately


    )


    thereafter and he indicated that the machine had _old dried blood on it and that he did not see the stains/dried blood on it prior to using it for the resident.

  3. That Petitioner's representative observed resident room number 304 of the Respondent facility during the survey and noted as follows:

    1. The room was on contact isolation for resident number sixty (60) in the first bed.


    2. There were three (3) red bins to indicate the precautions.


    3. The nurse stated that the resident was on contact isolation for extended-spectrum beta-lactamases (ESBL) in the urine, described as gram negative bacilli and capable of efficiently hydrolyzing penicillin, narrow spectrum cephalosporin.

    4. The second bed was resident number· seventy-seven (77) with diagnosis of end stage renal disease and currently on dialysis treatments three (3) times a week.

      e-.

      The resident had recently returned from the hospital with an infected gastrostomy tube.

  4. That Petitioner's representative noted that resident number seventy-seven (77) had been


    _, assessed as continent of bowel.


    37-. That Petitioner's representative interviewed Respondent's director of nursing on


    February 9, 2012 regarding the residents in room 304 and the director indicated as follows:


    1. The two (2) residents in the room do not use the bathroom, and there is no risk for contamination.

    2. The facility does not have a policy regarding sharing rooms with residents on


contact precautions.


  1. That Petitioner's representative interviewed resident number seventy-seven (77) on February 9, 2012, who indicated that the resident uses the bathroom when for bowel movements and that there was a commode chair at the bedside that the resident uses once in a while.

  2. That Petitioner's representative observed wound care to the foot ofresident number sixty-


eight (68) on February 9, 2012 at 10:30 a.m. and noted as follows:


1

J a. The resident's right bigtoenail was thick, discolored, long, and jagged edged.


j b. The resident's right little toe was thick, long, and discolored.

J

' c. Th.e resident's left foot toenails were thick, whitish in color, and long.

40, That Petitioner's representative interviewed the nurse and certified nursing assistant (CNA) for resident number seventy-seven (77) on February 9, 2012, who verified the observations above noted and indicated that they did not know if the resident had been referred to and/or seen a podiatrist.

  1. That Petitioner's representative reviewed Respondent's records related to resident number sixty-eight during the survey and noted as follows:

    1. The resident's admission orders dated August 4, 2011 provided as follows: "Consult: May have dental, podiatry, ophthalmic, psych, audio as needed."

    2. The medical record and the nursing unit's podiatry referral list did not reflect the resident had been seen by, nor referred to, the podiatrist since admission on August 4, 2011.

  2. That Petitioner's representative interviewed Respondent's unit coordinator on February 9, 2012 related to resident number sixty-eight (68) who indicated as follows:

    1. He validated that that resident had not been referred to and/or seen the podiatrist since admission.

    2. He immediately placed the name of the resident on the nursing unit's podiatry referral list and stated that he would have the podiatrist check the resident's feet.

  3. That on February 10, 2012, a podiatrist came to the facility to see resident number sixty-


    . eight (68) and noted the following:

    1. "Evaluation per the request of nursing staff to assess a chief complaint of toenails which are thick elongated and cause pain, snagging on sheets and socks thereby


      increasing the risk for traumatic avulsion as well as other soft tissue complications. Evaluation per the request of the nursing staff to assess a chief complaint of discoloration on the right great toe "

    2. The podiatrist's treatment included: "Debridement of mycotic toenails via mechanical and electrical means.... Patient is not a candidate for oral antifungal. I therefore recommend daily application of tincture to infected toenails."

    3. The assessment diagnoses in the podiatry progress notes included onychomycosis, pain secondary to onychomycosis, subungual hematoma of right great toe, and injury to the toenail.

  4. That the above reflects Resp9ndent's failure to ensure the provision of adequate and . appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative

    services consistent with the resident care plan, and with e.stablished and recognized practice standards within the community and or failed to ensure the facility was maintained in a safe manner where Respondent failed, inter alia, to:

    1. Ensure effective pain management to resident's receiving wound car.


    2. Ensure wound care was provided as prescribed.


    3. Ensure that recognized infection control procedures are followed related to medication administration, contact isolation, and assistance with dining.

    4. Ensure prescribed podiatric care is provided in a timely manner.


  5. That the Agency determined that these failures compromised the resident's. ability to maintain or reach his or her highest practicable physical, mental, and psychosocial well-being, as defined by an accurate and comprehensive resident assessment, plan of care, and provision of services and cited this deficient practice as an Isolated State Class II deficiency.



    WHEREFORE, the Agency seeks to impose an administrative fine in the amount of two thousand five hundred dollars ($2,500.00) against Respondent, a skilled nursing facility in the State of Florida, pursuant to §§ 400.23(8)(b) and 400.102, Florida Statutes (2011).

    COUNT!!


  6. The Agency re-alleges and incorporates paragraphs one (1) through five (5) and Counts and II of this Complaint as if fully set forth herein.

  7. Based upon Respondent's cited State Isolated Class II deficiency, it was not in substantial compliance at the time of the survey with criteria established under Part JI of Florida Statute 400, or the rules adopted by the Agency, a violation subjecting it to assigmnent of a conditional licensure status under§ 400.23(7)(a), Florida Statutes (2011).

WHEREFORE, the Agency intends to assign a conditional Jicensure status to Respondent, a skilled nursing facility in the State of Florida, pursuant to § 400.23(7), Florida Statutes (2011) commencing February I0, 2012.

'

I

1

Respectfully submitted this S:::y of June, 2012.

I


J. Walsh II, Esquire "" 'lY.ar, No. 566365

Ag ncy for Health Care Admin. 525 Mirror Lake Drive, 3300 St. Petersburg, FL 33701 727.552.1947 (office)


DISPLAY OF LICENSE


Pursuant to § 400.23(7)(e), Fla. Stat. (2011), Respondent shall post the most current license in a prominent place that is in clear and unobstructed public view, at or near, the place where residents are being admitted to the facility.


Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. Respondent has the right to retain, and be represented by an attorney in this matter. Specific options for administrative action are set out in the attached Election of Rights.


\ \

) )


All requests for hearing shall be made to the attention of: The Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, Bldg. #3, MS #3, Tallahassee, Florida, 32308, (850)

412-3630.


RESPONDENT IS FURTHER NOTIFIED THAT A REQUEST FOR HEARING MUST BE RECEIVED WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT OR WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY.


CERTIFICATE OF SERVICE


I HEREBY CERTIFY that a true and correct copy of the foregoing has been served by

U.S. Certified Mail, Return Receipt No. 700310100001 36004484 Stephen A. Rykiel, Administrator and Regis ered Agent, Florida ealthcare Mana?emF,1,LLP d/b/a Ocoee Health Care Center, 1556 Magwre Road, Ocoee, Florida 34761, on this ..3i_ day of June, 2012.


alsh II, Esquire ar:No. 566365

ency for Health Care Admin.

525 Mirror Lake Drive, 330G St. Petersburg, FL 33701 727.552.1947 (office)


Copies furnished to:


Stephen A. Rykiel Administrator and Reg. Agent Florida Healthcare Management, LLLP d/b/a Ocoee Health Care Center 1556 Maguire Road

Ocoee, Florida 34761 (US Certified Mail)


Patricia Caufman Field Office Manager

Agency for Health Care Admin. (Interoffice Mail)


Thomas J. Walsh, II Senior Attorney

Agency for Health Care Admin. 525 Mirror Lake Drive, #3300

St. Petersburg, FL 33701 1

(Interoffice Mail)


CERTIFICATE#: 17526


State of Florida

LICENSE#: SNF13870961 ·

AGENCY FOR HEALTH CARE ADMINISTRATION

DIVISION OF HEALTH QUALITY ASSURANCE


NURSING HOME

CONDITIONAL


This is to confum that FLORIDA HEALTHCARE MANAGEMENT, LLLP has complied with the.rules .ani:l regulations adopted. by the State of Florida, Agency For Health Care Administration, authorized in Chapter 400; Part II, Florida.Statutes, and as .the·

licensee is authorized to operate the following:


OCOEE HEALTH CARE CENTER 1556 MAGUIRE RD

OCOEE, FL 34761


TOTAL: 120 BEDS



STATUS CHANGE EFFECTIVE DATE: 02/10/2012

EXPIRATION DATE: 10/31/2013


. ·,·,---,· ---·--· I'

I



::.._ .=,:_. :.:.:;::ij::1:1l1 1W1:K t'.>=:·

i, StephenA R.vklel . .... ... . ...

I·'Florida Healthc111e Management LLLP

j' .Administtator & Registered Agent

. d/b/a Ocoee HealthcCare Center

j 1556 Maguire Road

i

\.

Ocoee, FL 34761

I

! S f'Qmi- lit1, FebiU ry 20Q.4

. Dameiiia Fiefum Reoelpt

'--•• • •

•,       ._,w.•--•,, •••-·••••• •

.

,



Docket for Case No: 12-002247

Orders for Case No: 12-002247
Issue Date Document Summary
Sep. 07, 2012 Agency Final Order
Source:  Florida - Division of Administrative Hearings

Can't find what you're looking for?

Post a free question on our public forum.
Ask a Question
Search for lawyers by practice areas.
Find a Lawyer