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