STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

PSL OPERATING FLORIDA, LLC, d/b/a SUMMIT AT VENICE,

2014 SEP 22 A 11: 40

Petitioner,

V.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

AHCA Nos. 2013008639

2013011466

RENDITION NO.: AHCA- / 4 - 0 j CfO -S-OLC

./

FINAL ORDER

THIS CAUSE came on for consideration before the Agency for Health Care Administration ("the Agency"), which finds and concludes as follows:

1. The Agency issued the Petitioner ("the Applicant") the attached Second Amended Notice of Intent to Deny (Ex. 1). Case No. 2013008639. In addition, the Agency has an open case number 2013011466 for an administrative fine in the sum of $500.00. The parties entered into the attached Settlement Agreement (Ex. 2), which is adopted and incorporated by reference.

   
   

2. The parties shall comply with the terms of the Settlement Agreement.

   
   

3. The Second Amended Notice of Intent to Deny is withdrawn.

   
   

4. The Applicant shall pay the Agency ten thousand dollars ($10,000.00) by March 2, 2015, with the license being surrendered if the payment is late or missed. Payment made on March 3, 2015 or thereafter, shall be deemed late or missed. A check made payable to the "Agency for Health Care Administration" containing the AHCA number(s) should be sent to:

   
   

   Agency for Health Care Administration Office of Finance and Accounting Revenue Management Unit

   2727 Mahan Drive, MS# 14

   Tallahassee, Florida 32308

   
   

5. The Agency will issue a standard license for the facility effective upon the completed execution of this Settlement Agreement. Unless surrendered, the license will be valid until the survey cycle of May, 2015. The Agency will conduct the facility's biennial survey before the expiration of the May 2015 license and within the Agency's timeframes as defined by protocol. The Agency will then complete annual surveys of the facility from that date through the next survey cycle expiration in May,

   
   

   Filed October 16, 2014 3:45 PM Division of Admin1istrative Hearings

   2017. If there are any Class 1, Class 2 or uncorrected 3 or 4 deficiencies during any survey cycle, or before May, 2017, the facility agrees to relinquish its license. If there are any complaints which result in a Class 1, Class 2 or uncorrected 3 or 4 deficiencies during this time frame, the facility agrees to relinquish its license.

   
   

6. Any requests for an administrative hearing are withdrawn. The parties shall bear their own costs and attorney's fees. This matter is closed.

ORDERED in Tallahassee, Florida, on this '22-day of_ ' 2014.

A

cretary

are Administration

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party that is adversely affected by this Final Order is entitled to seek 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

Richard Shoop, Agency Cler

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

Tallahassee, Florida 32308-5403

Telephone (850) 412-3630

Docket for Case No: 13-003523

Orders for Case No: 13-003523