STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, Vv. AHCA Nos. 2017002836 Former License No. 10666 RUDY’S AGAPE HOUSE, LLC, File No. 11966465 Provider Type: Closed Assisted Living Facility Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, State of Florida, Agency for Health Care Administration (“the Agency”), by and through the undersigned counsel, and files this Administrative Complaint against the Respondent, Rudy’s Agape House, LLC (“the Respondent”), pursuant to Sections 120.569 and 120.57, Florida Statutes (2016), and alleges: NATURE OF THE ACTION This is an action to impose an administrative fine of $12,500.00 against the Respondent, Rudy’s Agape House, LLC, for closing an assisted living facility without providing the Agency prior notice of the closure and discharging 15 residents from the assisted living facility without providing the residents sufficient notice of the discharge. PARTIES 1. The Agency is the licensing and regulatory authority that oversees assisted living facilities in Florida and enforces the applicable state statutes and rules governing such facilities. Ch. 408, Part II, Ch. 429, Part I, Fla. Stat. (2016); Ch. 58A-5, Fla. Admin, Code. The Agency may deny, revoke, and suspend any license issued to an assisted living facility and impose an administrative fine for a violation of the Health Care Licensing Procedures Act, the authorizing statutes or applicable rules. §§ 408.813, 408.815, 429.14, 429.19, Fla. Stat. (2016). In addition to licensure denial, revocation or suspension, or any administrative fine imposed, the Agency may assess a survey fee against an assisted living facility. § 429.19(7), Fla. Stat. (2016). 2. The Respondent was issued a license by the Agency to operate an assisted living facility (“the Facility”) located at 5426 18th Street West, Bradenton, Florida 34207, and was at all times material required to comply with the applicable statutes and rules governing assisted living facilities. The Respondent was licensed for this location until it voluntarily surrendered its license to the Agency on March 13, 2017. In addition, in May of 2016, the Respondent was issued a license by the Agency to operate a second assisted living facility (Rudy’s Agape House II) at 2104 55th Avenue West, Bradenton, Florida 34207. COUNT I Failure to Provide the Agency Prior Notice of Facility Closure 3. Under Florida law, (4) Whenever a licensee discontinues operation of a provider: (a) The licensee must inform the agency not less than 30 days prior to the discontinuance of operation and inform clients of such discontinuance as required by authorizing statutes. Immediately upon discontinuance of operation by a provider, the licensee shall surrender the license to the agency and the license shall be canceled. (b) The licensee shall remain responsible for retaining and appropriately distributing all records within the timeframes prescribed in authorizing statutes and applicable rules. In addition, the licensee or, in the event of death or dissolution of a licensee, the estate or agent of the licensee shall: 1. Make arrangements to forward records for each client to one of the following, based upon the client’s choice: the client or the client’s legal representative, the client’s attending physician, or the health care provider where the client currently receives services; or 2. Cause a notice to be published in the newspaper of greatest general circulation in the county in which the provider was located that advises clients of the discontinuance of the provider operation. The notice must inform clients that they may obtain copies of their records and specify the name, address, and telephone number of the person from whom the copies of records may be obtained. The notice must appear at least once a week for 4 consecutive wecks. § 408.810(4), Fla. Stat. (2016). 4. Under Florida law, in addition to the requirements of part II of chapter 408, the facility shall inform each resident or the next of kin, legal representative, or agency acting on each resident’s behalf, of the fact and the proposed time of discontinuance of operation, following the notification requirements provided in s. 429.28(1)(k). In the event a resident has no person to represent him or her, the facility shall be responsible for referral to an appropriate social service agency for placement. § 429.31(1), Fla. Stat. (2016). 5. Under Florida law, the Agency may levy a fine in an amount no greater than $5,000 upon each person or business entity that owns any interest in a facility that terminates operation without providing notice to the Agency and the residents of the facility at least 30 days before operation ceases. This fine shall not be levied against any facility involuntarily closed at the initiation of the Agency. The Agency shall use the proceeds of the fines to operate the facility until all residents of the facility are relocated. § 429.31(4), Fla. Stat. (2016). 6. In February 2017, the Respondent’s landlord filed a county court action against the Respondent seeking possession of the assisted living facility premises. 7. On March 13, 2017, the Respondent sent correspondence to the Agency stating that it had attempted to negotiate a new lease with its landlord without success and believed that as of March 1, 2017, it would still be able to negotiate a new lease. 8. The negotiations allegedly failed on or about March 7, 2017. 9. In the March 13, 2017, correspondence, the Respondent also stated that it was closing this assisted living facility, moving all of the residents of this assisted living facility, and requesting the Agency to “please close license #10666 effective immediately.” 10. The Respondent failed to inform the Agency not less than 30 days prior to the discontinuance of operation and inform clients of such discontinuance as required by law. 11. The Respondent terminated its operation without providing notice to the Agency and the residents of the facility at least 30 days before the operation of the facility ceased. WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, seeks to impose an administrative fine of $5,000 against the Respondent. COUNT II Resident Rights 12. Under Florida law, no resident of an assisted living facility shall be deprived of any civil or legal rights, benefits, or privileges guaranteed by law, the Constitution of the State of Florida, or the Constitution of the United States as a resident of a facility. Every resident of a facility shall have the right to: ... At least 45 days’ notice of relocation or termination of residency from the facility unless, for medical reasons, the resident is certified by a physician to require an emergency relocation to a facility providing a more skilled level of care or the resident engages in a pattern of conduct that is harmful or offensive to other residents. In the case of a resident who has been adjudicated mentally incapacitated, the guardian shall be given at least 45 days’ notice of a nonemergency relocation or residency termination. Reasons for relocation shall be set forth in writing. In order for a facility to terminate the residency of an individual without notice as provided herein, the facility shall show good cause in a court of competent jurisdiction. § 429.28(1)(k), Fla. Stat. (2016): 13. Under Florida law, if the facility is unable to meet the resident’s needs, as determined by the facility administrator or health care provider, the resident must be discharged in accordance with Section 429.28, Florida Statutes. Fla. Admin. Code R. 58A-5.0181(5). 14, In February 2017, a county court civil action was filed against the Respondent for possession of the assisted living facility premises. 15. On various dates in early March 2017, the Respondent discharged fifteen (15) residents from this assisted living facility without providing the residents 45 days prior written notice as required by Section 429.28, Florida Statutes (2016). 16. On March 13, 2017, the Respondent sent correspondence to the Agency stating that it was closing this assisted living facility, moving all of the residents of this assisted living facility, and requesting the Agency to “please close license #10666 effective immediately.” 17. | The Respondent did not have and did not demonstrate good cause to terminate the residency of these fifteen residents from this assisted living facility. 18. The abrupt termination of residency of each of the fifteen residents without prior written notification to the resident constituted a violation of resident rights for each resident as set forth within Section 429.28, Florida Statutes (2016). 19. Under Florida law, as a penalty for any violation of this part, authorizing statutes, or applicable rules, the Agency may impose an administrative fine. § 408.813(1), Fla. Stat. (2016). 20. Under Florida law, the Agency may impose an administrative fine for a violation that is not designated as a class [, class II, class III, or class IV violation. Unless otherwise specified by law, the amount of the fine may not exceed $500 for each violation. Unclassified violations include: Violating any provision of this part, authorizing statutes, or applicable rules. § 408.813(3)(b), Fla. Stat. (2016). WHEREFORE, the Petitioner, State of Florida, Agency for Health Care Administration, seeks to impose an administrative fine of $7,500.00 against the Respondent. Respectfully Submitted, / 7) Antdnio Lozada, Assistant G al Counsel Florida Bar No. ee Office of the General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 7 Tallahassee, Florida 32308 Telephone (850) 412-3699 Facsimile (850) 922-9634 Email: Antonio. Lozada@ahca.myflorida.com NOTICE Pursuant to Section 120.569, F.S., any party has the right to request an administrative hearing by filing a request with the Agency Clerk. In order to obtain a formal hearing before the Division of Administrative Hearings under Section 120.57(1), F.S., however, a party must file a request for an administrative hearing that complies with the requirements of Rule 28-106.2015, Florida Administrative Code. Specific options for administrative action are set out in the attached Election of Rights form. The Election of Rights form or request for hearing must be filed with the Agency Clerk for the Agency for Health Care Administration within 21 days of the day the Administrative Complaint was received. If the Election of Rights form or request for hearing is not timely received by the Agency Clerk by 5:00 p.m. Eastern Time on the 21st day, the right to a hearing will be waived. A copy of the Election of Rights form or request for hearing must also be sent to the attorney who issued the Administrative Complaint at his or her address. The Election of Rights form shall be addressed to: Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 3, Tallahassee, FL 32308; Telephone (850) 412-3630, Facsimile (850) 921-0158. Any party who appears in any agency proceeding has the right, at his or her own expense, to be accompanied, represented, and advised by counsel or other qualified representative. Mediation under Section 120.573, F.S., is available if the Agency agrees, and if available, the pursuit of mediation will not adversely affect the right to administrative proceedings in the event mediation does not result in a settlement. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the Administrative Complaint and Election of Rights fo a2 designated on this day of March, 2017. were served to the below named persons/entities by the method | Antonio Lozada, Assistant Genera Florida Bar No. 112613 — Office of the General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 7 Tallahassee, Florida 32308 Telephone (850) 412-3699 Facsimile (850) 922-9634 Email: Antonio.Lozada@ahca.myflorida.com Nancy Cushman, Administrator Rudy’s Agape House, LLC 5426 18th Street West Bradenton, Florida 34207 (U.S. Mail) Nancy Cushman, Administrator Rudy’s Agape House, LLC 2104 55th Avenue West Bradenton, Florida 34207 (U.S. Mail) Nancy Cushman, Registered Agent Rudy’s Agape House, LLC 1502 27th Street West Bradenton, Florida 34205 Certified Mail Copy: Patricia Caufman, Field Office Manager Paul Brown, Supervisor Laura Manville, Unit Manager i Nancy Cushman, Administrator Electronic Mail STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION Re: Rudy’s Agape House, LLC ACHA No. 2017002836 ELECTION OF RIGHTS This Election of Rights form is attached to an Administrative Complaint. It may be returned by mail or facsimile transmission, but_must_be received _by the Agency Clerk within 21 days, by 5:00 pm, Eastern Time, of the day you received the Administrative Complaint. If your Election of Rights form or request for hearing is not received by the Agency Clerk within 21 days of the day you received the Administrative Complaint, you will have waived your right to contest the proposed agency action and a Final Order will be issued imposing the sanction alleged in the Administrative Complaint. (Please use this form unless you, your attorney or your representative prefer to reply according to Chapter120, Florida Statutes, and Chapter 28, Florida Administrative Code.) Please return your Election of Rights form to this address: Agency for Health Care Administration Attention: Agency Clerk 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Telephone: 850-412-3630 — Facsimile: 850-921-0158 PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS OPTION ONE (1) I admit to the allegations of fact and conclusions of law alleged in the Administrative Complaint and waive my right to object and to have a hearing. I understand that by giving up the right to object and have a hearing, a Final Order will be issued that adopts the allegations of fact and conclusions of law alleged in the Administrative Complaint and imposes the sanction alleged in the Administrative Complaint. OPTION TWO (2) I admit to the allegations of fact alleged in the Administrative Complaint, but wish to be heard at an informal proceeding (pursuant to Section 120.57(2), Florida Statutes) where I may submit testimony and written evidence to the Agency to show that the proposed agency action is too severe or that the sanction should be reduced. OPTION THREE (3) I dispute the allegations of fact alleged in the Administrative Complaint and request a formal hearing (pursuant to Section 120.57(1), Florida Statutes) before an Administrative Law Judge appointed by the Division of Administrative Hearings. PLEASE NOTE: Choosing OPTION THREE (3), by itself, is NOT sufficient to obtain a formal hearing. You also must file a written petition in order to obtain a formal hearing before the Division of Administrative Hearings under Section 120.57(1), Florida Statutes. It must be received by the Agency Clerk at the address above within 21 days of your receipt of this proposed agency action. The request for formal hearing must conform to the requirements of Rule 28-106.2015, Florida Administrative Code, which requires that it contain: 1. The name, address, telephone number, and facsimile number (if any) of the Respondent. 2. The name, address, telephone number and facsimile number of the attorney or qualified representative of the Respondent (if any) upon whom service of pleadings and other papers shail be made. 3. A statement requesting an administrative hearing identifying those material facts that are in dispute. If there are none, the petition must so indicate. 4. A statement of when the respondent received notice of the administrative complaint. 5. A statement including the file number to the administrative complaint. Mediation under Section 120.573, Florida Statutes, may be available in this matter if the Agency agrees. Licensee Name: Contact Person: Title: Address: Number and Street City Zip Code Telephone No. Fax No. E-Mail (optional) I hereby certify that I am duly authorized to submit this Election of Rights form to the Agency for Health Care Administration on behalf of the licensee referred to above. Signed: Date: Printed Name: Title:

Docket for Case No: 17-003334

Orders for Case No: 17-003334