Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: PINEWOOD ESTATES ASSISTED LIVING FACILITY, D/B/A PINEWOOD ESTATES ASSISTED LIVING FACILITY
Judges: ROBERT S. COHEN
Agency: Agency for Health Care Administration
Locations: Sebastian, Florida
Filed: Mar. 23, 2018
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, January 11, 2019.
Latest Update: Feb. 20, 2019
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
STATE OF FLORIDA, AGENCY FOR HEALTH
CARE ADMINISTRATION,
AHCA No.: 2017005633
Petitioner, Return Receipt Requested:
7013 2250 0001 4950 2816
v.
PINEWOOD ESTATES ASSISTED LIVING
FACILITY, LLC d/b/a PINEWOOD ESTATES
LIVING FACILITY
Respondent
ADMINISTRATIVE COMPLAINT
COMES NOW State of Florida, Agency for Health Care Administration (““AHCA” or
“Agency” or “Petitioner”), by and through the undersigned counsel, and files this administrative
complaint against Pinewood Estates Assisted Living Facility, LLC d/b/a Pinewood Estates
Assisted Living Facility (hereinafter Pinewood or Respondent or facility), pursuant to Chapter
429, Part I, Chapter 408, Part II, Chapter 58A-5, Florida Administrative Code, and Section
120.60, Florida Statutes (2015), and alleges:
NATURE OF THE ACTION
1. This is an action to impose an administrative fine of $2,000.00 pursuant to
Sections 429.14 and 429.19, Florida Statutes (2016), for the protection of public health, safety
and welfare.
JURISDICTION AND VENUE
2. This Court has jurisdiction pursuant to Sections 120.569 and 120.57, Florida
Statutes (2016), and Chapter 28-106, Florida Administrative Code (2012).
3 Venue lies pursuant to Rule 28-106.207, Florida Administrative Code (2012).
PARTIES
4, AHCA is the regulatory authority responsible for licensure and enforcement of all
applicable statutes and rules governing assisted living facilities pursuant to Chapter 429, Part I,
Chapter 408, Part 1, Florida Statutes (2016), and Chapter 58A-5 Florida Administrative Code
(2012).
5. Respondent operates a 6-bed assisted living facility located at 4055 Pinewood
Road, Melbourne, Florida 32934. Respondent is licensed as an assisted living facility under
license number 12678. Respondent was at al! times material hereto a licensed facility under the
licensing authority of AHCA and was required to comply with all applicable rules and statutes.
COUNT L(TAG 081)
RESPONDENT FAILED TO PROVIDE OR ARRANGE FOR ONE OUT OF FOUR
SAMPLED STAFF (C) TO RECEIVE THE MANDATED IN-SERVICE TRAINING
RULE 584-5,0191(2), FLORIDA ADMINISTRATIVE CODE
(STAFF IN-SERVICE TRAINING }
UNCORRECTED CLASS I
6, AHCA re-alleges and incorporates paragraphs {1) and (5) as if fully set forth
herein.
7. Respondent was cited with deficient practice as the result of a follow up to a
monitoring visit to an Extended Congregate Care survey which survey was conducted on
September 27, 2016.
8. Based on interview and personnel record review the facility did not provide or
arrange for 1 of 4 sampled staff (C) to receive the mandated in-service trainings.
9. During the entrance interview on 9/27/16 at 10 AM the assistant to the facility
owner stated that nothing previously cited for staff C, the Advanced Registered Nurse
Practitioner (ARNP) was corrected because nothing really needed correcting. She placed a call to
the Agency office in Tallahassee as it was her understanding that the Tallassee office was in
agreement with her The Agency representative placed a phone call to the local Area office 7, was
instructed to return later during the day.
10. During the entrance interview on 9/27/16 at 2 PM the assistant to the facility
owner said that staff C who had a PHD (doctorate degree) in nursing and was not doing any of
the in-services including Resident Rights in an assisted living facility and Recognizing
abuse/neglect and exploitation as she was some type of trainer herself. An opportunity was
provided to contact the ARNP and look into whether the ARNP had attended the ALF Core
training (assisted living facility) core training and submit the ALF Core training certificate by
closing of business on 9/27/16 by e mail.
11. An email was received on 9/27/16 at 8:44 PM, however there was no evidence
staff C had attended the Assisted Living Core training or was exempt from the 1-hour in-service
training regarding Resident Rights in an assisted living facility and Recognizing abuse/neglect
and exploitation.
12. Respondent was cited with deficient practice as the result of a second revisit to an
Extended Congregate Care survey conducted on November 21, 2016. The deficiency remained
uncorrected.
13. Based on observation and interview, the facility failed to ensure that 1 of 2
sampled staff had received the required training within 30 days of employment (B).
14. There was no documentation to show that Staff B (hired 5/20/15) received the
required training in Resident Rights or Recognizing Abuse, Neglect and Exploitation. The
assistant to the Administrator stated on 11/21/16 at 4:20 PM, "This was all cleared by
Tallahassee. I don’t need to show you anything."
15. Based on the foregoing, Respondent violated Rule 58A-5.0191(2), Florida
Administrative Code, an uncorrected class III, that carries, in this case, an assessed fine of
$1,000.00.
COUNT II (TAG A090)
RESPONDENT FAILED TO ENSURE THAT ONE OUT OF FOUR SAMPLED
STAFF (C) RECEIVED AN IN-SERVICE TRAINING REGARDING THE FACILITY’S
DO NOT RESUSCITATE ORDERS (DNRO) POLICIES AND PROCEDURES
RULE 58A-5.0191(11), FLORIDA ADMINISTRATIVE CODE
(TRAINING - DO NOT RESUSCITATE ORDERS )
UNCORRECTED CLASS III
16. | AHCA re-alleges and incorporates paragraphs (1) and (5) as if fully set forth
herein.
17. Respondent was cited with deficient practice as the result of a follow up to a
monitoring visit to an Extended Congregate Care survey conducted on 9/27/16.
18. Based on interview and record review the facility failed to ensure 1 of 4 sampled
staff (C) received an in-service training regarding the facility’s Do Not Resuscitate Orders
(DNRO) policies and procedures.
19. During the entrance interview on 9/27/16 at 10 AM the assistant to the facility
owner stated that nothing previously cited for staff C, the Advanced Registered Nurse
Practitioner (ARNP) was corrected because nothing really needed correcting. She placed a call to
the Agency office in Tallahassee as it was her understanding that the Tallassee office was in
agreement with her. The Agency representative place a phone call to the local Area office 7, was
instructed to return later during the day.
20. During the entrance interview on 9/27/16 at 2 PM, the assistant to the facility
owner said that staff C who had a PHD (doctorate degree) in nursing and was not doing any of
the in-services including the Do Not Resuscitate Orders (DNRO) policies and procedures. She
added that it had something to do with her liability insurance and too much time spent on these
in-services.
21. Respondent was cited with deficient practice as the result of a second revisit to an
Extended Congregate Care survey conducted on 11/21/16. The Agency found that the deficiency
remained uncorrected.
22. Based on observation and interview, the facility failed to ensure that 1 of 2
sampled staff (had received the required training (B).
23. | There was no documentation that Staff B (hired 5/20/15) completed the training in
Do Not Resuscitate Orders as required. The assistant to the Administrator stated on 11/21/16 at
4:20 PM, " This was all cleared by Tallahassee. I don’t need to show you anything."
24. Based on the foregoing Respondent violated Rule S8A-5.0191(11), Florida
Administrative Code, an uncorrected class III deficiency that carries, in this case, an assessed
fine of $1,000.00.
CLAIM FOR RELIEF
WHEREFORE, the Agency requests the Court to order the following relief:
1. Enter a judgment in favor of the Agency for Health Care Administration against
Respondent on Counts I and II.
2. Assess an administrative fine in the amount of $2,000.00 against Respondent
based on Counts I and II.
3: Assess costs related to the investigation and prosecution of this matter, if the
Court finds costs applicable.
4. Grant such other relief as this Court deems is just and proper.
Respondent is notified that it has a right to request an administrative hearing pursuant to
Sections 120.569 and 120.57, Florida Statutes (2016). Specific options for administrative action
are set out in the attached Election of Rights. All requests for hearing shall be made to the
Agency for Health Care Administration, and delivered to the Agency Clerk, Agency for Health
Care Administration, 2727 Mahan Drive, MS #3, Tallahassee, Florida 32308.
RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE
A REQUEST FOR A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF
THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED
IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY.
IF YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO BE
REPRESENTED BY AN ATTORNEY IN THIS MATTER
le, pom vu
jurdes A. Naranjo, Esq.
Fla. Bar No.: 997315
Assistant General Counsel
Agency for Health Care Administration
525 Mirror Lake Drive North, suite 330
St. Petersburg, Florida 33702
727-552-1944
Copies furnished to:
Theresa DeCanio
Field Office Manager
Agency for Health Care Administration
Hurston South Tower
400 Robinson, Suite $309
Orlando, Fla. 32801
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished
by U.S. Certified Mail, Return Receipt Requested, to Peter Fellows, Administrator, wie
Estates Assisted Living Facility, 4055 Pinewood Road, Melbourne, Fla. w4 on this iy
of January, 2018. ;
[lira
s A. Naranjo, Esq.
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
Re: Pinewood Estates Living Facility
AHCA No. 2017005633
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 shall
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:
Contac 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:
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MELBOURNE, FL 32934
Docket for Case No: 18-001586
Issue Date |
Proceedings |
Feb. 20, 2019 |
Final Order filed.
|
Jan. 11, 2019 |
Order Closing Files and Relinquishing Jurisdiction. CASE CLOSED.
|
Jan. 10, 2019 |
AHCA's Response to the Court's Order to Show Cause filed.
|
Jan. 07, 2019 |
AHCA's Status Report filed.
|
Dec. 28, 2018 |
Order to Show Cause.
|
Oct. 31, 2018 |
Order Continuing Case in Abeyance (parties to advise status by January 7, 2019).
|
Oct. 15, 2018 |
Notice of Unavailability filed.
|
Sep. 24, 2018 |
AHCA's Notice of Status of the Cases and Requests that the Cases be Held in Abeyance until the Final Order is entered on the Notice of Intent to Deny Case filed.
|
Jul. 24, 2018 |
Order Continuing Cases in Abeyance (parties to advise status by September 24, 2018).
|
Jul. 09, 2018 |
Order Granting Motion to Withdraw as Counsel for Respondent.
|
Jul. 09, 2018 |
Notice of Transfer.
|
Jun. 15, 2018 |
AHCA's Status Report and Notice of Unavailability filed.
|
Jun. 13, 2018 |
Notice of Unavailability filed.
|
May 17, 2018 |
(Proposed) Order Granting Motion to Withdraw as Counsel for Respondent filed.
|
May 17, 2018 |
Motion to Withdraw as Counsel for Respondent filed.
|
Apr. 30, 2018 |
Order Granting Continuance and Placing Case in Abeyance (parties to advise status by June 15, 2018).
|
Apr. 17, 2018 |
Joint Stipulation to Abate Proceedings filed.
|
Apr. 16, 2018 |
Notice of Appearance (E. Patrick Buntz) filed.
|
Apr. 16, 2018 |
Notice of Appearance and Incorporated Motion for Stay filed.
|
Apr. 16, 2018 |
Notice of Appearance (Derek Daniels) filed.
|
Apr. 16, 2018 |
Respondent's Motion for Enlargement of Time filed.
|
Apr. 09, 2018 |
Notice of Hearing (hearing set for June 7, 2018; 9:30 a.m.; Sebastian, FL).
|
Apr. 09, 2018 |
Order of Consolidation (DOAH Case Nos. 18-1586, 18-1588, and 18-1591).
|
Apr. 09, 2018 |
AHCA's Motion to Consolidate filed.
|
Apr. 02, 2018 |
Unilateral Response to Initial Order filed.
|
Mar. 26, 2018 |
Initial Order.
|
Mar. 23, 2018 |
Election of Rights filed.
|
Mar. 23, 2018 |
Petition for Formal Administrative Hearing filed.
|
Mar. 23, 2018 |
Administrative Complaint filed.
|
Mar. 23, 2018 |
Notice (of Agency referral) filed.
|
Orders for Case No: 18-001586