Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: MADISON HEALTH INVESTORS LLC, D/B/A LAKE PARK OF MADISON
Judges: BARBARA J. STAROS
Agency: Agency for Health Care Administration
Locations: Madison, Florida
Filed: Jun. 24, 2002
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, November 1, 2002.
Latest Update: Dec. 24, 2024
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION JUN -L 02
AHCA
AGENCY FOR HEALTH CARE DEPARTMENT CLERK
ADMINISTRATION,
Petitioner, eo
_ rm
vs. AHCA NO. 2002026191 «:
MADISON HEALTH INVESTORS L.C.,
d/b/a LAKE PARK OF MADISON,
Respondent.
2-3s3)e B
0D mB
/ ‘ s
ADMINISTRATIVE COMPLAINT
COMES NOW the AGENCY FOR HEALTH CARE ADMINISTRATION
(hereinafter “AHCA”),
by and through
its undersigned counsel,
and files this Administrative Compl
aint against MADISON HEALTH
INVESTORS L.C. d/b/a LAKE PARK OF MADISON (hereinafter “Lake
Park of Madison”), pursuant to Section 120.569,
Florida Statutes (2001), an
and 120.57,
d alleges:
NATURE OF THE ACTION
1. This
is an action to assign a conditional license to
Lake Park of Madison pursuant to Section 400.23({7), Florida
Statutes (2001), and to assess costs
investigation and prosecution of this ca
400.121(10),
related to the
ge pursuant to Section
Florida Statutes
(2001). The original conditional
license is attached hereto as Exhibit
wat
JURISDICTION AND VENUE
2. Thig Court has jurisdiction pursuant to Sections
120.569 and 120.57, Florida Statutes (2001).
3. AHCA has jurisdiction pursuant to Chapter 400, Part
Il, Florida Statutes (2001).
4. Venue shall be determined pursuant to Rule 28-106.207,
Florida Administrative Code (2001).
PARTIES
5. AHCA is the regulatory agency responsible for
licensure of nursing homes and enforcement of all applicable
Florida laws and rules governing skilled nursing facilities
pursuant to Chapter 400, Part II, Florida Statutes, and Chapter
59A-4, Florida Administrative Code.
6. Madison Health Investors L.C., doing business as Lake
Park of Madison, is a Florida limited liability company with a
principal address of 75 South Church Street, Suite 650,
Pittsfield, Maine 01201.
7. Lake Park of Madison is a 120-bed skilled nursing
facility located at 1900 Country Club Drive, Madison, Florida
32340. Lake Park of Madison ig licensed by AHCA as a skilled
nursing facility having been issued license number SNF16360961,
certificate number 8499, with an effective date of March 14,
2002 and an expiration date of August 31, 2002.
8. Lake Park of Madison is and was at all times material
hereto a licensed skilled nursing facility required to comply
with Chapter 400, Part II, Florida Statutes and Chapter 59A-4,
Florida Administrative Code.
COUNT I
EFFECTIVE MARCH 14, 2002, AHCA ASSIGNED A CONDITIONAL LICENSURE
STATUS TO LAKE PARK OF MADISON BASED UPON THE DETERMINATION
THAT LAKE PARK OF MADISON WAS NOT IN SUBSTANTIAL COMPLIANCE WITH
APPLICABLE LAWS AND RULES DUE TO THE PRESENCE OF
ONE OR MORE CLASS Il DEFICIENCIES
AT THE MOST RECENT SURVEY OF MARCH 11-14, 2002.
§ 400.23(7), Fla. Stat. (2001)
9. AHCA re-alleges and incorporates by reference
paragraphs one (1) through eight (8) above as if fully set forth
herein.
10. On or about March 41-14, 2002 AHCA conducted a survey
at Lake Park of Madison and found two class II deficiencies.
FIRST CLASS IT DEFICIENCY
11. On or about March 11-14, 2002 one class II deficiency
was cited against Lake Park of Madison based upon the findings
below involving resident #8.
Resident_#8
12. On or about March 11-14, an AHCA surveyor reviewed
Resident #8's medical record. The resident has history of a
pruritic condition (1.¢€., frequent scratching at arms, legs and
face as a manifestation) . The minimum data set dated January
30, 2002 yevealed that the resident had areas of broken skin and
was to receive skin treatments to alleviate the condition. The
current care plan, however, failed to address the prurigo areas.
The care plan did not contain any prevention or treatment
methods for these areas.
13. On or about March 11-14, 2002, an AHCA surveyor
observed resident #8 lying in bed. The resident had a
gerisleeve on one arm and kling gauze around one elbow. The
surveyor observed multiple open areas on the resident’s arms,
including skin tears with scabs, round scab areas (prurigo), and
scars from both the prurigo and skin tears. The surveyor
further observed that the linens were dotted with a dark, blood-
like substance, which a nurse said was old blood from
scratching.
14. Lake Park of Madison failed to develop an accurate
comprehensive care plan for resident #8 by failing to include in
the care plan measurable objectives and timetables to meet the
resident's medical, nursing, and mental and psychosocial needs.
15. Based on all the foregoing, Lake Park of Madison
violated: (a) 42 CFR § 483.20(k) via Rule 59A-4.1288, Florida
administrative Code, by failing to develop a comprehensive care
plan for resident #8 that includes measurable objectives and
timetables to meet the resident’s medical, nursing, and mental
and psychosocial needs that are identified in the comprehensive
assessment; and (b) Rule 59A-4.109(2), Florida Administrative
Code, by failing to develop a comprehensive care plan for
resident #8 that includes measurable objectives and timetables
to meet the resident’s medical, nursing, mental and psychosocial
needs that are identified in the comprehensive assessment. The
care plan must describe the services that are to be furnished to
attain or maintain the resident’s highest practicable physical,
mental and social well-being.
16. Pursuant to Section 400.23 (8) (b), Florida Statutes,
the foregoing violation is a class II violation because it
compromised resident #8'Ss ability to maintain or reach his or
her highest practicable physical, mental, and psychosocial well-
being.
SECOND CLASS II DEFICIENCY
17. On or about March 11-14, 2002, AHCA conducted a survey
at Lake Park of Madison. One class II deficiency was cited
against Lake Park of Madison based upon the findings below
involving resident #8.
Resident #8
18. On or about March 11-14, 2002 an AHCA surveyor
reviewed Resident #8’s medical record. Resident #8 was admitted
to Lake Park of Madison on March 11, 1997 with a history of a
pruritic condition (i.e., frequent scratching at arms, legs and
face as a manifestation) . A review of the minimum data set
dated January 20, 2002 revealed that the resident had areas of
broken skin and was to receive skin treatments to alleviate the
condition. The current care plan did not address the frequent
prurigo areas. There wags no prevention and treatment methods
for these areas.
19. On or about March 11-14, 2002, the surveyor observed
resident #8 lying in bed. The resident had a gerisleeve on one
arm and kling gauze around one elbow. The surveyor observed the
open areas on the resident’s arms. There were fresh scabs and
healed skin tears and old scratch areas. There were also stains
of dark blood-like substance on the bed linens.
20. Resident #8’s medical record contained a physician's
order for Derma-Smoothe FS 0.01% Oil to be applied to affected
areas every day after a bath, and a physician’s order for
Temovate Emollient Cream 0.05% to be applied to spots twice
daily as needed. The February and March, 2002 treatment
administration records revealed that neither the Derma-Smoothe
nor the Temovate Emollient Cream had been applied to the
resident at all in February. As of the date of the surveyor,
March 11-14, 2002, the Derma-Smoothe had only been applied to
the resident’s affected areas once in March. The oil and cream
is used to soothe affected areas and prevent further breakouts
of "itchy" areas.
21. The nurses’ notes revealed multiple instances of
observations of scratching or complaints of itching on February
10, 14, 20, 26 and March 6 and 13, 2002. The only intervention
noted was the administration of Atarax. There was no
documentation of topical treatments being applied to the
resident’s skin for soothing.
22. On or about March 11-14, 2002 an AHCA_ surveyor
interviewed Lake Park of Madison’s Certified Nursing Assistant
(“CNA”). The CNA was unaware of the need to apply oil and cream
to the resident’s skin. The CNA had never seen either being
used on the resident.
23. On or about March 11-14, 2002 an AHCA surveyor
interviewed Lake Park of Madison’s registered nurse (“RN”). The
RN said she believed that the treatment nurse was to apply the
oil. The RN did not know that resident #8 was not receiving the
necessary skin treatment.
24. Lake Park of Madison failed to provide necessary care
and services to attain or maintain resident 8's highest
practicable physical, mental and psychosocial well-being.
25. Based on all of the foregoing, Lake Park of Madison
violated Title 42 CFR § 483.25 via Rule 59A-4.1288, Florida
Administrative Code, by failing to ensure that resident #8
received the necessary care and services to attain or maintain
the highest practicable physical, mental, and psychosocial well-
being.
26. Pursuant to Section 400.23(8)(b), Florida Statutes,
the foregoing violation is a class II violation because it
compromised each resident’s ability to maintain or reach his or
her highest practicable physical, mental, and psychosocial well-
being, as defined by an accurate and comprehensive resident
assessment, plan of care and provision of services.
27. Pursuant to Section 400.23(7), Florida Statutes, AHCA
assigned a conditional licensure status to the Lake Park of
Madison based upon the determination that the facility was not
in substantial compliance with applicable laws and rules due to
the presence of one or more class II deficiencies at the most
recent survey on or about March 14, 2002.
CLAIM FOR RELIEF
WHEREFORE, AHCA respectfully requests the following relief:
1) Make factual and legal findings in favor of
AHCA on Count I;
2) Uphold the issuance of the conditional
license, attached hereto as Exhibit “A”;
3) Assess costs related to the investigation
and prosecution of this case pursuant to
Section 400.121(10), Florida Statutes
(2001); and
4) Grant any other legal and equitable relief
as deemed necessary in the furtherance of
justice.
DISPLAY OF LICENSE
Pursuant to Sections 400.062(5) and 400.23(7) (e), Florida
Statutes, Lake Park of Madison shall post the license ina
prominent place that is in clear and unobstructed public view at
or near the place where residents are being admitted to the
facility.
NOTICE
Lake Park of Madison hereby is notified that it has a right
to request an administrative hearing pursuant to Section
120.569, Florida Statutes. Specific options for administrative
action are set out in the attached Election of Rights (one page)
and explained in the attached Explanation of Rights (one page).
All requests for hearing shall be made to the Agency for Health
Care Administration, and delivered to Lori C. Desnick, Senior
Attorney, Agency for Health Care Administration, 2727 Mahan
Drive, Mail Stop #3, Tallahassee, Florida, 32308.
LAKE PARK OF MADISON IS FURTHER NOTIFIED THAT THE FAILURE
TO REQUEST A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF
THIS ADMINISTRATIVE COMPLAINT WILL RESULT IN AN ADMISSION OF THE
FACTS ALLEGED IN THE ADMINISTRATIVE COMPLAINT AND THE ENTRY OF A
FINAL ORDER BY ACHA.
10
Respectfully submitted on this WHELAN day of May 2002.
Aine C Deavncel
Lori C. Desnick
Fla. Bar. No. 0129542
Counsel for Petitioner
Agency for Health Care Administration
Building 3, Mail Stop #3
2727 Mahan Drive
Tallahassee, Florida 32308
(850) 921-0071 (office)
(850) 921-0158 (fax)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the
Administrative Complaint and the original conditional license
attached thereto as Exhibit “A” has been sent by U.S. Certified
Mail Return Receipt Requested (return receipt # 7106 4575 1294
2049 9290) to Allyson Burwin, Administrator, Madison Health
Investors L.C. d/b/a Lake Park of Madison, 1900 Country Club
Drive, Madison, Florida 32340 and that a true and correct copy
of the Administrative Complaint and Exhibit “A” has been. sent by
U.S. Certified Mail Return Receipt Requested (return receipt #
7106 4575 1294 2049 9306) to C.T. Corporation System, 1200 South
Pine Island Road, Plantation, Florida 33324, Registered Agent
for Madison Health Investors L.C. d/b/a Lake Park of Madison, on
this 17™ day of May, ee Qerrete
LORI C. DESNICK, ESQUIRE
CERTIFICATE #: 8499 LICENSE #: _SNF16360961
: State of Florida
AGENCY FOR HEALTH CARE ADMINISTRATION
DIVISION OF MANAGED CARE AND HEALTH QUALITY
SKILLED NURSING FACILITY
CONDITIONAL
This is to confirm that_ MADISON HEALTH INVESTORS LLC_has complied with the rules and regulations adopted by the
State of Florida, Agency For Health Care Administration, authorized in Chapter 400, Part II, Florida Statutes, and as the
licensee is authorized to operate the following:
LAKE PARK OF MADISON
1900 COUNTRY CLUB DRIVE
MADISON, FL 32340
with 120 beds.
Change In Status
ACTION EFFECTIVE DATE: 03/14/2002
LICENSE EXPIRATION DATE: _08/31/2002 Deputy Secretary,
Exhibit “A”
CONDITIONAL LICENSE
License # SNF16360961; Certificate #8499
Effective Date: 3/14/2002
Expiration Date: 8/31/2002
12
State of Florida
Division of Administrative Hearings
Sharyn L. Smith The DeSoto Building
Director and Chief Judge 1230 Aplalachee Parkway
Ann Cole Tallahassee, Florida
Clerk of the Division 32399-3060
Cecil Howard, General Counsel
Florida Commission on Human Relations
2009 Apalachee Parkway, Suite 100
Tallahassee, Florida 32301
Re: MARGIE R. ISRAEL vs. WAL-MART STORES, INC.,
DOAH Case No. 01-2818
Dear Mr. Howard:
Enclosed is my Recommended Order in the referenced case.
Also enclosed is the two volume transcript, together with the
Petitioner's Exhibits numbered 1, and 3, which were admitted
into evidence, and Exhibits 2, 4, 5, and 6, which were not
admitted, and the Respondent's Exhibits numbered 1-5. Copies of
this letter will serve to notify the parties that my Recommended
Order and the hearing record have been transmitted this date.
As required by Subsection 120.57 (1) (k), Florida Statutes,
you are requested to furnish the Division of Administrative
Hearings with a copy of the Final Order within 15 days of its
rendition.
Sincerely,
\
y { scan
HARRY L. HOOPER
Administrative Law Judge
HLH/cdl
Enclosures
ec: Denise Crawford, Agency Clerk
Margie R. Israel
John A. Unzicker, Jr., Esquire
(850) 488-9675 + SUNCOM 278-9675 ° Fax Filing (850) 921-6847 * Fax SUNCOM 291-6847
www.doah.state.flus + E-mail Ann_Cole@doah.state.fl.us
Docket for Case No: 02-002531
Issue Date |
Proceedings |
Jun. 17, 2003 |
Final Order filed.
|
Nov. 01, 2002 |
Order Closing File issued. CASE CLOSED.
|
Nov. 01, 2002 |
Motion to Remand (filed Responent via facsimile).
|
Oct. 15, 2002 |
Order of Consolidation issued. (consolidated cases are: 02-002531, 02-002532)
|
Oct. 09, 2002 |
Respondent`s First Request to Produce to Petitioner (filed via facsimile).
|
Oct. 09, 2002 |
Motion to Consolidate (of case nos. 02-2532, 02-2531) (filed by Respondent via facsimile).
|
Oct. 04, 2002 |
Notice of Hearing issued (hearing set for November 4, 2002; 10:30am; Madison).
|
Sep. 17, 2002 |
Order Granting Continuance issued (parties to advise status by September 24, 2002).
|
Sep. 11, 2002 |
Motion for Continuance (filed by Respondent via facsimile).
|
Aug. 23, 2002 |
Agency for Health Care Administration`s First Set of Interrogatories and Request for Production of Documents (filed via facsimile).
|
Jul. 10, 2002 |
Order of Pre-hearing Instructions issued.
|
Jul. 10, 2002 |
Notice of Hearing issued (hearing set for September 24, 2002; 9:30 a.m.; Madison, FL).
|
Jul. 02, 2002 |
Response to Initial Order (filed by Petitioner via facsimile).
|
Jun. 25, 2002 |
Initial Order issued.
|
Jun. 24, 2002 |
Administrative Complaint filed.
|
Jun. 24, 2002 |
Petition for Formal Administrative Hearing filed.
|
Jun. 24, 2002 |
Notice filed.
|