STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION COT 16 G2 ST. ANNE’S NURSING CENTER & RESIDENCE nema yi INC. d/b/a SAINT ANNE’S NURSING CENTER, aan Petitioner, b eA ele AHCA 00201341 ef vs. DOAH No.: 02-2689 RENDITION NO.: AHCA-02- >S- OLC STATE OF FLORIDA, AGENCY FOR 3 on HEALTH CARE ADMINISTRATION, ain & po Respondent. ~ FINAL ORDER mo DS an The Agency for Health Care Administration, having entered into .a Joint Stipulation and Settlement Agreement with the parties to these proceedings, and being otherwise well advised in the premises, decides as follows: The attached Joint Stipulation and Settlement Agreement is approved and adopted as a part of this Final Order and the parties are directed to comply with the terms of the Joint Stipulation and Settlement Agreement. THEREFORE, it is ORDERED and ADJUDGED that the parties hereto are directed to comply with terms of the Joint Stipulation and Settlement Agreement. DONE and ORDERED this 7h say of Ctkiter , 2002, in Tallahassee, Leon County, Florida. Hikes M. Medows, é, Secfétary Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH AGENCY CLERK AND A SECOND COPY, ALONG WITH FILING FEE AS PRESCRIBED BY LAW, IN THE DISTRICT COURT OF APPEAL 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 THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Michael O. Mathis, Esq. ae sect Mea le Assistant General Counsel WO SS oe F At G CRF Agency for Health Care Administration “ { 2727 Mahan Dr., Suite 3808-D Tallahassee, Florida (Interoffice Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Bldg #1 Mail Stop Code #9 Tallahassee, Florida 32308 (Interoffice Mail) Gloria Collins Finance & Accounting Agency for Health Care Administration 2727 Mahan Drive Mail Stop Code #14 Tallahassee, Florida 32308 (Interoffice Mail) J. Patrick Fitzgerald, Esquire 110 Merrick Way, Suite 3-B 2180 Park Avenue North, #100 Cora! Gables, Florida 33134 Wendy Adams (Inter-office Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of this Fina! Order was served on the above-named person(s) by U.S. Mail, or the method designated, on this the IG day of O; LE Lith —_ 2002. Fs Chacha Ras “1 Lealand McCharen, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 €850)=922-5865 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION ST ANNE’S NURSING CENTER & RESIDENCE INC., d/b/a SAINT ANNE’ S NURSING CENTER, Petitioner, AHCA Case no. 2002013411 vs. Case. No. 02-2689 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. STIPULATION AND SETTLEMENT AGREEMENT Respondent, State of Florida, Agency for Health Care Administration (hereinafter the “Agency”) through their undersigned representatives, and St. Anne’s Nursing Center (hereinafter “St. Anne’s Nursing Center”) pursuant to Sec. 120.57(4), Florida Statutes (2001) each individually, a “party”, collectively as “parties,” hereby enter into this Stipulation and Settlement Agreement (“Agreement”) and agree as follows: WHEREAS, St. Anne’s Nursing Center is a nursing facility licensed pursuant to chapter 400.Part II, Fla. Stat (2001), and Chapter 59A4, Fla. Admin. Code (2002), and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over St. Anne’s Nursing Center pursuant to Chapter 120.569 and 120.57, Fla. Stat. (2001); and WHEREAS, the Agency served St. Anne’s Nursing Center with a notice of intent to impose late fine on February 26, 2002, notifying the party of its intent to impose a fine for Five Thousand dollars ($5,000.00), and; WHEREAS, St. Anne’s Nursing Center requested a formal administrative hearing in a letter to the Agency dated March 14, 2002; and WHEREAS, the parties have negotiated and agreed that the best interest of all the parties will be served by a settlement of this proceeding; and NOW THEREFORE, in consideration of the mutual promises and recitals herein, the parties intending to be legally bound, agree as follows: 1. All recitals are true and correct and are expressly incorporated herein. 2. Both parties agree that the “whereas” clauses incorporated herein are binding findings of the parties. 3. Upon full execution of this Agreement, St. Anne’s Nursing Center agrees to a withdrawal of its Petition for Formal Administrative Proceedings; agrees to waive any and all appeals and proceedings; agrees to waive compliance with the form of the Final Order (findings of fact and conclusions of law) to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), a formal proceeding under Subsection 120.57(1), appeals under Section 120.68, Florida Statutes; and declaratory and all writs of relief in any court or quasi- court (DOAH) of competent jurisdiction. 4, Upon full execution of this Agreement, St. Anne’s Nursing Center agrees to pay the sum of One Thousand dollars ($1,000.00) to the Agency within 30 days of the entry of the Final Order. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in the Circuit Court in Leon County, Florida. S. St. Anne’s Nursing Center neither admits nor denies the allegations raised in the Notice of Intent to Impose Late Fine referenced herein. The Agency agrees that it will not impose any further penalty against St. Anne’s Nursing Center as a result of the late filing of its renewal application that was four (4) days late as the facility license expires April 30, 2002, however, no agreement made herein shall preclude the Agency from imposing a penalty against St. Anne’s Nursing Center for any late fine or surveys identified in a future survey of St. Anne’s Nursing Center, which constitutes a “repeat” deficiency from the February 26, 2002 fine (s). The parties agree that in such ‘repeat” case the late renewal application from the February 26, 2002 fine (s) shall be deemed found without further proof. 6. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and dismissing the above-styled case. 7, Each party shall bear its own costs and attorney fees. 8. This Agreement shall become effective on the date upon which it is fully executed by all the parties. 9. St Anne’s Nursing Center for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the State of Florida, Agency for Health Care Administration, and its agents, representatives, and attorneys of and from all claims, demands, actions, causes of action, suits, damages, losses, and expenses, of any and every nature whatsoever, arising out of or in any way related to this matter and the Agency’s actions, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative forum, including any claims arising out of this agreement, by or on behalf of St Anne’s Nursing Center or related facilities. 10. This Agreement is binding upon all party’s herein and those identified in the aforementioned paragraph (1) of this Agreement. SEP-25-2002 23:89 11. The undersigned have read and understand bind their respective principals to it. AGENCY HEALTH CARE ADMIN Sep- 26-02 : a O2:02P Suzanne A. Dockerty, P-A. 305 443 9155 asa 921 8158 P.8S this Agreement and have authority to 12, This Agreement contains the entire understandings and agreements of the parties. 13, This Agreement supercedes any prior oral or written agreements becween the parties. 14. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void. The following representatives hereby ackn Agreement. Elizabeth Dudek Deputy Secretary, Managed Care and Health Quality Assurance Agency for Health Care DATED: __22. (3 [02 Migs Lah BG Valda C. Christian General Counsel, State of Fla. Agency for Health Care Admin. 2727 Mahan Drive owledge that they are duly authorized to enter into this DATED: Sept th ah J, Parric 110 Merrick Way, Suite 3-B Coral Gables, FL 33134 DATED: Ly f. 26 Ze [N YN Sar VN rprowv@ Michael O. Mathis, Esq Assistant General Counsel Agency for Health Care Administration TOTAL P.@5 -O5

Docket for Case No: 02-002689