STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, 6 | . IG 3 5. vs. : ; AHCA NO: 11-01- -0072 HME von. PACIFIC MEDICAL SERVICES, —_—sRReturn Receipt Requested INC., d/b/a PACIFIC MEDICAL . #70000520001672344728 SERVICES #70000520001672344735 Respondent. : ADMINISTRATIVE COMPLAINT YOU ARE HEREBY Ni OTIFIED that after Twenty One 21) days from the receipt, of this complaint, the Agency for Health Care Administration (hereinafter referred to as the ' Agency") intends to impose an administrative fine in the amount of Two thousand and Five Hundred (82, 500) Dollars to Pacific Medical Services The., (hereinafter referred to as Respondent: As grounds for this administrative fine, the Agency alleges as follows: 1. The Agency has jurisdiction over Respondent by virtue of the provisions of Chapter 400, Part X, Florida Statutes (Fla. Stat.). 2. At the time of the unannounced visit, Respondent was operating as an unlicensed home medical equipment (HME) provider at 7105 W 12 Avenue, Hialeah, Florida 33014, in violation of Chapter 400, Part X, (Fla. Stat.) and Chapter 59A-25, Florida Administrative Code (F.A.C.). 3. AHCA hand-served a notice of violation on Respondent on January 11, 2001 (attached as Exhibit 1). O os, f 4. The letter gave notice to Respondent that offering, advertising or operatingas “sy “ Lo home medical equipment provider without a license was a violation of law, to cst i a Oa te immediately; and of ABCA intention to proceed with all available remedies, including imposiitg a fine up to $5000 per Violation per day. 5. AHCA hand-served an n order to Cease and Desist to Respondent on or about, Ji January 29, 2001 (attached as Exhibit 2). 6. The order gave notice to Respondent to. cease and desist from. operating as as a a home “Hees medical equipment provider. 7. On or about February 9, 2001, AHCA Conducted an unannounced visit to Respondent. 8. Asurvey of the business revealed that Respondent was offering, selling and renting home medical equipment (affidavit of Rene Fletcher attached as Exhibit 3). 9. It was determined at the time of the unannounced visit that Respondent was offering and advertising home medical equipment services to the public without a license, in violation of section 400. 93(6), Fla. Stat., which provides: “It is unlawful for any person to offer or advertise home medical and services unless he or she has a valid license under this part or is exempted from licensure under subsection (5).” 10. Respondent does not qualify for exemption under subsection 400.93 (5), Fla. Stat. 11. It was also determined that at the time of the unannounced visit that Respondent was operating as an unlicensed home medical equipment provider, in violation of section 400.93, Fla. Stat. 10. The above referenced violations constitute grounds to levy this administrative fine pursuant to 400.932, which states that the Agency may impose an administrative fine up to $5000 per violation per day for any violation of Chapter 400, Part X, Fla. Stat., or applicable tule. : ENTRY 0 OF A FINAL L ORDER BY THE AGENCY. OO ENE EES Ow ¢ OE. ila 3 ELECTION AND EXPLANATION OF RIGHTS FORMS ATTACHED 11. RESPONDENT IS FURTHER NOTIFIED THAT Fi 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 I HEREBY CERTIFY that a true copy hereof was sent by U.S. Certified Mail, Return Receipt Requested to Pacific Medical Services Inc., 7105 W 12 Avenue, Hialeah; FL 33014 on this_&¢_day of Ail. , 2001. A Liatebl Diane Castillo Field Office Manager Agency for Health Care __ Administration Copy to: Luis M. Vissepo II Benjamin R. Metsch Assistant General Counsel Metsch and Metsch, P.A. Agency for Health Care Administration 1455 NW 14 St. Manchester Building Miami, FL 33125 8355 NW 53" Street : Miami, Florida 33166 Home Care Unit Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 Gloria Collins, Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #14 Tallahassee, Florida 32308 pry | STATE OF FLORIDA _ ae AGENCY FOR HEALTH CARE ADMINISTRATION JEB BUSH, GOVERNOR HAND DELIVERED BY: (SIGNED AND DATED) (PRINT NAME) DELIVERED TO: S ) + : 3 NED AND. ED) = en aie! We bei chat. 4 (PRINT NAME) # 3 oO x NOTICE OF VIOLATION 3 ——ererre_e reve. e S January 5, 2001 : Mr. Domingo Diaz : Pacific Medical Services, Inc. 7105 W 12 Ave. . : Hialeah, FL 33014 ; ‘ Dear Mr. Diaz: . You are hereby notified that the Agency for Health Care Administration considers you to be operating as a Home Medical Equipment Provider without being licensed. Based on Florida Statutes 400.93(6), it is unlawful for any person to offer or advertise home medical equipment and services to the public, as defined in section 400.925 Florida Statute, without first obtaining a valid license from this Agency. Section 400.925(8), Florida Statute, defines-home medical equipment as “any product as defined by the Federal Drug Administration, Devices and Cosmetics Act, any products reimbursed under the Medicare Part B Durable Medical Equipment benefits, or any products reimbursed under the Florida Medicaid durable medical equipment program. Home medical equipment includes, but is not limited to, oxygen and related respiratory equipment. TALLAHASSEE, FL 32308 i MAIL STOCK CODE: 34 2727 MAHAN DRIVE HOME CARE UNIT Pacific Medical Services Page Two Home medical equipment includes customized wheelchairs and related seating and positioning, but does not include prosthetics or orthotics or any splints, braces or aids custom fabricated by a licensed health care practitioner.” no - Section 400.925 (11) defines home medical equipment services as “equipment management and consumer instructions, including selection, delivery setup, and maintenance of equipment, and other related services for the use of home medical | equipment i in the consumer’s regular or temporary place of residence. a : Based on evidence of unlicensed activity, the Agency intends to proceed with all available legal action, including bringing injunctive proceedings against you in a court of competent _ jurisdiction, to insure that you immediately cease and desist from offering these services. Other legal action may include an administrative fine as permitted by Section 400.932, Florida Statute, which states that the Agency may impose an administrative fine up to $5000 per violation per day for any violation of Chapter 400, Part X, Florida Statute, or applicable rule. If you believe you are not operating as a Home Medical Equipment provider in violation of law _ as described, you may submit in writing any information which would demonstrate that to the Agency within 24 hours of receipt of this notice. Any information you wish to have considered by the Agency must be actually received within 24 hours of your receipt of this Notice of Violation by Diane Lopez Castillo, Field Office Manager, Agency for Health Care Administration, 8355 NW 53” Street, Koger Center, 1 Floor, Manchester Building, Miami, FL 33166. If you have any questions, Ms. Diane Lopez Castillo may be reached at (305) 499-2165 or by fax number at (305) 499-2190. Sincerely, Home Care Unit Supervisor ce: Diane Castillo Luis M. Vissepd

Docket for Case No: 01-001933