Petitioner: GENESIS ELDERCARE, D/B/A BRANDYWYNE LAKESIDE CENTER
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: DANIEL MANRY
Agency: Agency for Health Care Administration
Locations: Orlando, Florida
Filed: Sep. 28, 2001
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, November 27, 2001.
Latest Update: Dec. 22, 2024
STATE OF FLORIDA
AGENCY FOR HEATH CARE ADMINISTRATION
GENESIS ELDERCARE d/b/a
BRANDYWYNE CONVALESCENT CENTER
FAIRWAY OAKS CENTER
ISLAND LAKE CENTER
RULEME CENTER
TIERRA PINES CENTER,
Petitioner, DS M coved
vs. CASE NO. 01-3813;..
01-3814 oO
AGENCY FOR HEALTH CARE 01-3815
ADMINISTRATION, 01-3816
Respondent.
/
FINAL ORDER
THE PARTIES resolved all disputed issues and executed
a “settlement agreement”, which is incorporated by
reference. The parties are directed to comply with the
terms of the “settlement agreement”. Based on the
foregoing, this proceeding is CLOSED.
Lhe
DONE and ORDERED on this the day of
Cer Ber. , 2002, in Tallahassee, Florida.
Rhonda M. fafa —
Agency for Health Care Administration
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.
Copies furnished to:
Mr. Joseph G. Dvorak
Vice President of Reimbursement
Genesis Eldercare
515 Fairmount Avenue
Towson, MD 21286
Kim A. Kellum, Esquire
Attorney for Agency
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive
Fort Knox Building 3, Mail Stop 3
Tallahassee, Florida 32308
D.S. Manry
Administrative Law Judge
Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
Willie Bivens, Finance and Accounting
~ CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the
foregoing has been furnished to the above named addressees
by U.S. Mail on this the Lop day of (Ockok ¥£. ,
2002.
Chaclaré Tas
8*tealand McCharen, Esquire
Agency Clerk
State of Florida
Agency for Health Care
Administration
2727 Mahan Drive,
Building #3, Mail Stop 3
Tallahassee, Florida 32308-5403
_! Ol re CT
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS2
GENESIS ELDERCARE d/b/a:
BRANDYWYNE CONVALESCENT CENTER
FAIRWAY OAKS CENTER
ISLAND LAKE CENTER
RULEME CENTER
TIERRA PINES CENTER
Petitioner,
DOAH CASE NO: 01-3813
01-3814
01-3815
v. 01-3816
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and GENESIS ELDERCARE,
(“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows:
1, This Agreement is entered into between the parties for the purpose of avoiding the
costs and burdens of litigation.
2. PROVIDER is a Medicaid provider in the State of Florida that is subject to audits
by the Agency.
3. The Agency conducted audits of Genesis Eldercare d/b/a Brandywyne
Convalescent Center for the period ending September 30, 1997, Genesis Eldercare
d/b/a Fairway Oaks Center for the period ending January 31, 1997, Genesis
“Eldercare d/b/a Island Lake Center for the period ending September 30, 1997,
Genesis Eldercare d/b/a Ruleme Center for the period ending May 31, 1997,
Genesis Eldercare d/b/a Tierra Pines Center for the period ending January 31,
1997.
In its Audit Reports issued on July 11, 2001, AHCA notified PROVIDER that
review of the cost reports revealed that, in its opinion, some claims in whole or in
part were not covered by Medicaid. The Agency further notified PROVIDER of
the adjustments which AHCA was making to the cost reports. In response to the
Audit Reports, PROVIDER filed a petition for a formal administrative hearing,
By way of its petitions for formal administrative hearings, PROVIDER identified
specific adjustments that it appealed.
Subsequent to filing the petition, AHCA and PROVIDER exchanged documents
and discussed each of the adjustments that were at issue,
As a result of the aforementioned exchanges, the parties agree that the Agency’s
adjustments which were the subject of these proceedings, as they relate to the
above-referenced cost reports, shall be resolved as follows:
Brandywyne Convalescent Center
a. No revisions
Fairway Oaks Center
a. No revisions
Island Lake Center
a. Adjustment #2 will be removed.
b. Adjustment #5 will be removed.
“c. Adjustment #8 will be removed.
Ruleme Center
a. Adjustment #10 will be removed.
b. Adjustment #1 will be reduced to $12,735.
c. Adjustment #6 will be reduced to $39,614.
d. Page 7 of the audit report shows the average equity in capital assets being
reduced by $583,571. This adjustment will be removed and the “as adjusted”
average equity in capital assets will be increased to $1,172,870.
e. Pages 7 and 13 of the audit report will be modified to reduce the adjustment
for capital additions from $66,544 to $34,017. The capital replacements
adjustments will be reduced form $235,215 to $6,619. The capital
replacement pass through cost adjustments will be reduced from $15,656 to
$1,655.
Tierra Pines
a. Adjustment #3 will be removed,
b. Adjustment # 12 will be removed.
In order to resolve this matter without further administrative proceedings,
PROVIDER and AHCA expressly agree that the adjustment resolution, as set
forth above, will resolve and settle this case completely and release both parties
from all liabilities arising from the findings in the audits referenced as: NH99-
023R, NH99-024R, NH99-026R, NH99-027R, NH99-031R.
9.
11,
12.
13,
PROVIDER further agrees that the Agency shall recalculate the per diem rate for
“these time periods, and that where PROVIDER was overpaid, PROVIDER will
remit payment to the Agency in the full amount of the overpayment within forty-
five (45) days of such notice.
Payment shall be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
And payment shall clearly indicate that it is per a settlement agreement, shall
reference the DOAH Case Number, and shall reference the audit number.
PROVIDER agrees that failure to pay any monies due and owing under the terms
of this Agreement shall constitute PROVIDER’S authorization for the Agency,
without further notice, to withhold the total remaining amount due under the
terms of this agreement from any monies due and owing to PROVIDER for any
Medicaid claims.
AHCA reserves the right to enforce this Agreement under the laws of the
State of Florida, the Rules of the Medicaid Program, and all other applicable rules
and Regulations.
This settlement does not constitute an admission of wrongdoing or error by either
party with respect to these cases or any other matter. However, the parties believe
that this matter should be settled because the parties have agreed to the terms
contained within this agreement.
Each party shall bear its own attorneys’ fees and costs, if any.
15.
18,
The signatories to this Agreement, acting in a representative capacity, represent
“that they are duly authorized to.enter into this Agreement on behalf of the
respective parties. Furthermore, PROVIDER agrees that his signature alone binds
him to make the payment as set forth in this agreement. The parties further agree
that a facsimile or photocopy reproduction of this agreement with PROVIDER’S
signature shall be sufficient for the Agency to enforce the agreement and to cancel
the hearing in this matter.
This Agreement shall be construed in accordance with the provisions of the laws
of Florida. Venue for any action arising from this Agreement shall be in Leon
County, Florida.
This Agreement constitutes the entire agreement between PROVIDER and the
AHCA, including anyone acting for, associated with or employed by them,
concerning all matters and supersedes any prior discussions, agreements or
understandings; there are no promises, representations or agreements between
PROVIDER and the AHCA other than as set forth herein. No modification or
waiver of any provision shall be valid unless a written amendment to the
Agreement is completed and properly executed by the parties,
This is an Agreement of settlement and compromise, made in recognition that the
parties may have different or incorrect understandings, information and
contentions, as to facts and law, and with each party compromising and settling
any potential correctness or incorrectness of its understandings, information and
contentions as to facts and law, so that no misunderstanding or misinformation
shall be a ground for rescission hereof.
19.
20.
21.
22.
23.
24,
PROVIDER expressly waives in this matter its right to any hearing pursuant to
“Sections 120.569 or 120.57, Florida Statutes, the making of findings of fact and
conclusions of law by the Agency, and all further and other proceedings to which
it may be entitled by law or rules of the Agency regarding this proceeding and any
and all issues raised herein. PROVIDER further agrees that the Agency should
issue a Final Order which is consistent with the terms of this settlement, that
adopts this Agreement and closes this matter.
This Agreement is and shall be deemed jointly drafted and written by all parties to
it and shall not be construed or interpreted against the party originating or
preparing it.
To the extent that any provision of this Agreement is prohibited by law for any
reason, such provision shall be effective to the extent not so prohibited, and such
prohibition shall not affect any other provision of this Agreement.
This Agreement shall inure to the benefit of and be binding on each party’s
successors, assigns, heirs, administrators, representatives and trustees,
All times stated herein are of the essence of this Agreement.
This Agreement shall be in full force and effect upon execution by the respective
parties in counterpart.
GENESIS ELDERCARE
poll Dated: __& | lo 2002
Mr. Joseph G. Ipvorak
Vice Presidént of Reimbursement
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
Boe [lupe Dated: oly 2002
Bob Sharpe
Deputy Secretary of Medicaid
Malt Lng Dated: VAL , 2002
ith Vaile Chasthy
Acting General Counsel
Docket for Case No: 01-003813
Issue Date |
Proceedings |
Oct. 21, 2002 |
Final Order filed.
|
Nov. 27, 2001 |
Order Closing File issued. CASE CLOSED.
|
Nov. 26, 2001 |
Joint Motion for Remand (filed via facsimile).
|
Nov. 07, 2001 |
Notice of Hearing issued (hearing set for November 28 and 29, 2001; 9:30 a.m.; Orlando, FL).
|
Nov. 05, 2001 |
Order of Consolidation issued. (consolidated cases are: 01-003813, 01-003814, 01-003815)
|
Oct. 04, 2001 |
Order to Show Cause issued (parties to respond to this order by October 15, 2001).
|
Oct. 01, 2001 |
Initial Order issued.
|
Sep. 28, 2001 |
Request for Hearing filed.
|
Sep. 28, 2001 |
Notice of Related Petitions filed.
|
Sep. 28, 2001 |
Notice of Completion of Audit Report filed.
|
Sep. 28, 2001 |
Notice (of Agency referral) filed.
|