11/18/02 17:03 FAX . . : 002/019 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION we LEC =o Pp pe ae STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, O87 4747 Petitioner, ‘ AHCA NO: 2002046 vs. EMERALD OAKS HEALTH CARE ASSOCIATES, LLC., d/b/a MAGNOLIA HEALTH AND REHABILITATION CENTER, Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter wAHCA”), by and through the undersigned counsel, and files this Administrative Complaint against EMERALD OAKS. HEALTH CARE ASSOCIATES, LLC., d/b/a MAGNOLIA HEALTH AND REHABILITATION CENTER (hereinafter “Respondent”) and alleges: NATURE OF THE ACTION 1. Thia is an action to impose .an administrative fine on MAGNOLIA HEALTH AND REHABILITATION CENTER, in the amount of One Thousand Dollars ($1,000) pursuant to Sections 400.23(7) (b) and 400.23(8) (c) Florida Statutes. 2. The Respondent was cited for the deficiency during the follow up survey conducted on or about September 11, 2002 froma prior survey of August 08, 2002. The original mandated correction date was September 08, 2002. 11/18/02 17:03 FAX ; ; 003/019 JURISDICTION AND VENUE 3. The Agency hag jurisdiction over the Respondent pursuant to Chapter 400, Part II, Florida Statutes. 4. Venue lies in Sarasota County, Division of Administrative Hearings, pursuant to 120,57 Florida Statutes, and Chapter 28, Florida Administrative Code. PARTIES 5. AHCA, is the enforcing authority with regard to nursing home licensure law pursuant to Chapter 400, Part ITI, Florida Statutes and Rules 59A-4, Florida Administrative Code. 6. Respondent igs a nursing home located at 1507 S. Tuttle Avenue, Saragota, FL 34239. The facility is licensed under Chapter 400, Part II, Florida Statutes and Chapter 59A-4, Florida Administrative Code. COUNT I RESPONDENT FAILED TO PROVIDE NEEDED RESIDENT MEDICATIONS IN A TIMELY MANNER; VIOLATING Fl. Admin Code R. 59A-4.1288 INCORPORATING BY REFERENCE 42 CFR 483.60; § 400,022 (1) (1) FL. Stat. (2001) UNCORRECTED CLASS III DEFICIENCY 7. AHCA re-alleges and incorporates (1) through (6) as if fully set forth herein. 8. On or about August 8, 2002 an annual survey was conducted at the facility, 11/18/02 17:04 Fax oodso19 9. At that time, based on family and resident interview, record review and staff interview it was determined that that tacility[ failed to obtain a pain medication in a timely manner for one (Resident #15) of 18 active sampled residents as evidenced by medication not delivered to the facility for one week after ordered by the physician. Yo. On or about September 11, 2002 ARCA conducted a survey at Respondent’s facility. An uncorrected Class III deficiency was cited against Respondent based on'the findings below: a./ Based on staff and resident interview, the facility failed to provide needed resident medications in a timely manner as evidenced by: staff and resident complaints that medications run out and are not refilled promptly and that the facility continues to experience delays in obtaining medications for new or changed physician orders and/or newly admitted residents. The findings include: 1. During a confidential interview on 9/12/02, with a resident who is alert and oriented, he/she atated that sometimes medications are not reordered timely and then the pharmacy does not deliver the medications on time and he/she has to wait for the medication. The resident stated that this has not improved since the Annual Health Survey on 8/8/02. 2. During an interview with 2 facility staff nurses on 9/11/02, both stated that pharmacy services have not improved at all since the Annual Health Survey on 8/8/02. Both stated that sometimes the pharmacy has to be recalled several times to get a response. One nurse stated that the pharmacy service was "dangerous." These nurses were interviewed again on 9/12/02 for further clarification; they both stated that routine medications are supposed to be refilled automatically and that special orders have to be called and faxed inte the pharmacy. They both stated that even when the pharmacy is called and faxed, they are glow to respond and frequently have to be called repeatedly. 11/18/02 17:04 FAX 005/019 11. The above actions or inactions constitute a violation of Fl. Admin Code R.S9A-4.1288 incorporating 42 CFR 483.60 which requires in pertinent part that the facility must provide routine and emergency drugs and biologicals to its residents; and a violation of $400.022 (1) (1) which provides that residents have a right to adequate and appropriate health caré. 12. The above referenced violations constitute the gyounds for the one (1) imposed uncorrected Class III deficiency and for which a Fine of One Thousand Dollars ($1,000) is authorized under §400.022(3), §400.102(1) (a) (d), §400.121(1) and §400.23(8){(c) Florida Statutes. CLAIM FOR RELIEF WHEREFORE, AHCA requests this Court to order the following relief: A. Make factual and legal findings in favor of the Agency en Count I; Impose a fine of One Thousand Dellars ($1,000) for the violations cited in Count I, against the respondent under §400,102(1) (a) and (dad), $400,121(1}), and §400.23(8) (c), Florida Statutes; Assess costs related to the investigation and prosecution of this case pursuant to § 400.121 (10) Fl. Stat. (2001) All other general and equitable relief allowed by law. 11/18/02 17:04 Fax , Woos/oig9 NOTICE EMERALD OAKS HEALTH CARE ASSOCIATES, LLC., d/b/a MAGNOLIA HEALTH AND REHABILITATION CENTER is notified that it has a right toe request an administrative hearing pursuant to Section 120.569, Florida Statutes. Specific options for administrative action are set out in the attached Explanation of Rights (one page) and Election of Rights (one page). All requests for hearing shall be made to the attention of Eileen O'Hara Garcia, Senior Attorney, Agency for Health Care Administration, 525 Mirror Lake Drive, North, Sebring Building, Suite 330D, St. Petersburg, Florida 33701. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST A HEARING WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADNISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Ld er] Bileen O’Hara Gaycia, Esquire . Sebring Building, Suite 330D St. Petersburg, Florida 33701 (727) 552-1439 (office) (727) 552-1440 (FAX) 11/18/02 17:05 FAX L 007/019 I HEREBY CERTIFY that a copy hereof has been furnished to Emerald Oaks Health Care Associates, LLC, 400 Perimeter Center Terrace, Suite 650, Atlanta, Ga 30346, by U.S. Mail and to Admin., Magnolia Health and Rehabilitation Center, 1507 8s. Tuttle Avenue, Sarasota, FL 34239 by U.S. Certified Mail Return Receipt No.7002 2030 0002 7117 5867 Con) Novenber a i Elleen Of Hard @arcia,) Esquire Copies furnished tao: Emerald Oaks Health Care Asso. Registered Agent for Magnolia Health and Rehab. Center 400 Perimeter Center Terr, #650 Atlanta, Georgia 30346 (U.S. Mail) Administrator Magnolia Health & Rehab. Center 1507 8. Tuttle Avenue Sarasota, Florida 34239 (U.S. Certified Mail) Wendy Adams Agency for Health Care Administration 2727 Mahan Drive, Bldg #3 MS #3 Tallahassee, FL 32308 (Interoffice Mail) Molly McKinstry Long Term Care Agency for Health Care Administration 2727 Mahan Drive, Bldg #1, MS Code #33 Tallahassee, Florida 32308 (Interoffice Mail) Eileen O’ Hara Garcia AHCA - Senior Attorney 525 Mirror Lake Drive, North Saint Petersburg, Florida 33701 11/18/02 17:06 FAX tae . (oit/o19 STATE OF FLORIDA ve [ou nl My is tg AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA NO: 2002047909 vs. EMERALD OAKS HEALTH CARE ASSOCIATES, LLC., d/b/a MAGNOLIA HEALTH AND REHABILITATION CENTER, Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the Agency for Health Care Administration (hereinafter “AHCA”), by and through the undersigned counsel, and files this Administrative Complaint against EMERALD OAKS HEALTH CARE ASSOCIATES, LLC., d/b/a MAGNOLIA HEALTH AND REHABILITATION CENTER (hereinafter “Respondent”) and alleges: NATURE OF THE ACTION 1. This is an action to impose a conditional licensure atatua effective September 12, 2002, purgauant to Sections 400.23(7) (b) and 400.23(8)(c). The original conditional license is attached hereto as Exhibit “A”. 2. The Respondent was cited for the deficiency during the follow up survey conducted on or about September 11, 2002 from a prior survey of August 08, 2002. The original mandated correction date was September 08, 2002. 11/18/02 17:06 FAX ~ yo12/019 JURISDICTION AND VENUE 3. The Agency has jurisdiction over the Respondent pursuant to Chapter 400, Part II, Florida Statutes. 4, Venue lies in Sarasota County, Division of Administrative Hearings, pursuant to 120.57 Florida Statutes, and Chapter 28, Florida Administrative Code. PARTIES 5. AHCA, is the enforcing authority with regard to nursing home licensure law pursuant to Chapter 400, Part II, Florida Statutes and Rules 59A~4, Florida Administrative Code. 6. Respondent is a nursing home located at 1507 S. Tuttle Avenue, Sarasota, PL 34239. The facility is licensed under Chapter 400, Part II, Florida Statutes and Chapter 59A-4, Florida Administrative Code. CcoUNT Tf EFFECTIVE SEPTEMBER 12, 2002, AHCA ASSIGNED A CONDITIONAL LICENSURE STATUS TO THE RESPONDENT BASED UPON THE DETERMINATION THAT THE RESPONDENT WAS NOT IN SUBSTANTIAL COMPLIANCE WITH APPLICABLE LAWS AND RULES DUE TO THE PRESENCE OF ONE (1) UNCORRECTED CLASS III DEFICIENCY AT THE MOST RECENT SURVEY OF SEPTEMBER 11, 2002 §400.23 (7) (b) Fl. Stat. (2001) 7. AHCA re-alleges and incorporates (1) through (6) as if fully set forth herein. 8. On or about August 8, 2002 an annual survey was conducted at the facility. 41/18/02 17:07 FAX “e o13/o19 9. At that time, based on family and resident interview, record review and staff interview it was determined that that facility failed to obtain a pain medication in a timely manner for one (Resident #15) of 18 active sampled residents as evidenced by medication not delivered to the facility for one week after ordered by the physician. 10. On or about September 11, 2002 AHCA conducted a survey at Respondent’s facility. An uncorrected Class ILI deficiency was cited against Respondent based on the findings below: a./ Based on staff and resident interview, the facility failed to provide needed resident medications in a timely manner as evidenced by: staff and resident complaints that medications run out and are not refilled promptly and that the facility continues to experience delays in obtaining medications for new or changed physician orders and/or newly admitted residents. The findings include: 1. During a confidential interview on 9/12/02, with a resident who is alert and oriented, he/she stated that sometimes medications are not reordered timely and then the pharmacy does not deliver the medications on time and he/she has to wait for the medication, The resident stated that this has not improved since the Annual Health Survey on 8/8/02. 2. During an interview with 2 facility staff nurses on 9/11/02, both stated that pharmacy services have not improved at all since the Annual Health Survey on 8/8/02. Both stated that sometimes the pharmacy has to be recalled several times to get a response. One nurse stated that the pharmacy service was "dangerous." These nurses were interviewed again on 9/12/02 for further clarification; they both stated that routine medications are supposed to be refilled automatically and that special orders have to he called and faxed into the pharmacy. They both stated that even when the pharmacy is called and faxed, they are slow to respond and frequently have to be called repeatedly. 11/18/02 17:07 FAX Woid/org ll. The Agency seeks to impose a Conditional Licensure Status effective September 12, 2002, based on one uncorrected Class III deficiency as authorized under sections 400.23 (7) (b), 400.23(8) (c) Florida Statutes. CLAIM FOR RELIEF WHEREFORE, AHCA requests this Court to order the following relief: A. Make factual and legal findings in favor of the Agency on Count I; B. Recommend that the change of licensure status effective September 12, 2002, from Standard to Conditional be upheld; and Cc. Assess costs related to the investigation and presecution of this case pursuant to § 400.121 (10) FL. Stat. (2001) D All other general and equitable relief allowed by law. DISPLAY OF LICENSE Pursuant to Section 400.062(5) and Section 400.23(7) (e), Florida Statutes, EMERALD OAKS HEALTH CARE ASSOCIATES, LLC., d/b/a MAGNOLIA HEALTH AND REHABILITATION CENTER shall post the license in a prominent place that is in clear and unobstructed public view at or near the place where residents are being admitted to the facility. 11/18/02 17:07 FAX 015/019 NOTICE EMERALD OAKS HEALTH CARE ASSOCIATES, LLC., d/b/a MAGNOLIA HEALTH AND REHABILITATION CENTER is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Plorida Statutes. Specific options for administrative action are set out in the attached Explanation of Rights (one page) and Election of Rights (one page). All requests for hearing shall he made to the attention of Eileen O’Hara Garcia, Senior Attorney, Agency for Health Care Administration, 525 Mirror Lake Drive, North, Sebring Building, Suite 330D, St. Petersburg, Florida 33701. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST A HEARING WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY, ectfully submitted Eileen O’ Hara Garcia, AHCA — Senior Attorne 525 Mirror Lake Drive, North Sebring Building, Suite 330D St. Petersburg, Florida 33701 (727) 552-1439 (Office) (727) 552-1440 (FAX) 11/18/02 17:07 Fax ; _ “ @o16/019 I HEREBY CERTIFY that a copy hereof has been furnished to Emerald Oaks.Health Care Associates, LLC, 400 Perimeter Center Terrace, Suite 650, Atlanta, Georgia 30346, by U.S. Mail and to Administrator, Magnolia Health and Rehabilitation Center, 1507 S. Tuttle Avenue, Sarasota, Florida 34239 by U.S. Certified Mail Return Receipt No.7002 2030 0002 7109 5301, on November 2002. Eileen O/Hara Garcia, Asquire Copies furnished to: Emerald Oaks Health Care Associates, LLC Registered Agent for Magnolia Health and Rehabilitation Center 400 Perimeter Center Terrace, Suite 650 Atlanta, Georgia 30346 (U.S. Mail) Administrator : Magnolia Health and Rehabilitation Center 1507 S. Tuttle Avenue Sarasota, Florida 34239 (U.S. Certified Mail) Wendy Adams Agency for Health Care Administration 2727 Mahan Drive, Bldg #3 MS #3 Tallahassee, FL 32308 ({Interoffice Mail) Molly McKinstry Long Term Care Agency for Health Care Administration 2727 Mahan Drive, Bldg #1, MS Code #33 Tallahassee, Florida 32308 {Interoffice Mail) 11/18/02 17:08 Fax Eileen O'Hara Garcia AHCA ~ Senior Attorney 525 Mirror Lake Drive, North Sebring Building, Suite 330D Saint Petersburg, Florida 33701 a SST AN Wo17/o19

Docket for Case No: 02-004747