STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

vs. AHCA No. 2014003542

RENDITION NO.: AHCA· 15 • 00'21 ·S-OLC

EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY d/b/a

GOOD SAMARITAN

SOCIETY-KISSIMMEE VILLAGE

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:

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

   
   

2. The Respondent shall pay the Agency $43,500.00. 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

   
   

   Filed February 16, 2015 9:55 AM Division of Admin1istrative Hearings

3. Conditional licensure status is imposed on the Respondent beginning February 14, 2014, and ending April 8, 2014.

ORDERED at Tallahassee, Florida, on this _jJ_ day of_ ---'-,------''-='b""c....=...... ' 2015.

, Secretary

ea th Care Administration

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.

I CERTIFY that a true and corre py _Qf_!his Final Order was served on the below-named

persons by the method designated on this // bi-aiiy of r;:;;.,_,  

201-5

CERTIFICATE OF SERVICE

7 / ,

Richard Shoop, Agency Clerk

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

Tallahassee, Florida 32308-5403

Telephone: (850) 412-3630

2

Docket for Case No: 14-005088

Orders for Case No: 14-005088