STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

ZEPHYR HAVEN HEALTH AND REHAB CENTER, INC.,

Petitioner,

vs.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Provider No.: 032039100 Invoice No.: NH16752

RENDITION NO.: AHCA- / -0810 -S-MDA

Respondent.

/

FINAL ORDER

THE PARTIES resolved all disputed issues and executed a Settlement Agreement. The parties are directed to comply with the terms of the attached settlement agreement, attached hereto and incorporated herein as Exhibit "1." Based on the foregoing, this file is

CLOSED.

DONE and ORDERED on this the t(,day of f9/unlU', 2014, in Tallahassee, Florida.

EL DEK, SECRETARY

Agency for Health Care Administration

Final Order Invoice No. NH1675Z

Page 1 of3

Filed October 3, 2014 11:44 AM Division of Administrative Hearings

A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A 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 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.

Peter A. Lewis, Esquire Peter A Lewis, P.L.

3023 North Shannon Lakes Drive Suite 101

Tallahassee, Florida 32309 palewis@petelewislaw.com (Via Electronic Mail)

Bureau of Health Quality Assurance Agency for Health Care Administration

(Interoffice Mail)

Stuart Williams, General Counsel Agency for Health Care Administration

(Interoffice Mail)

Shena Grantham, Chief Medicaid FFS Counsel (Interoffice Mail)

Agency for Health Care Administration Bureau of Finance and Accounting (Interoffice Mail)

Jeffries Duvall, Esquire Assistant General Counsel

Agency for Health Care Administration (Interoffice Mail)

Zainab Day, Medicaid Audit Services Agency for Health Care Administration (Interoffice Mail)

State of Florida, Division of Administrative Hearings The Desoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060 (Via U.S. Mail)

CERTIFICATE OF SERVICE

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

to the above named addressees by the designated method of delivery on this the / y           

of a@ · .

2014.

Richard J. Shoop, Esquire Agency Clerk

State of Florida

Agency for Health Care Administration 2727 Mahan Drive, Building #3

Tallahassee, Florida 32308-5403

(850) 412-3671

Docket for Case No: 14-002056

Orders for Case No: 14-002056