STATE OF FLORIDA __AGENCY FOR B HEALTH CARE ADMINSTHAION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA NO: 2002049280 v. 2003000114 GINGER DRIVE HEALTH CARE ASSOCIATES, O2 156 of LLC, HERITAGE HEALTHCARE CENTER, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA”), by and through the undersigned counsel, and files this Administrative Complaint against GINGER DRIVE HEALTH CARE ASSOCIATES, LLC, d/b/a HERITAGE HEALTHCARE CENTER, (hereinafter “Heritage Healthcare Center ”), pursuant to Section 120.569, and 120.57, Florida Statutes, (2002), and alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine against Heritage Healthcare Center, pursuant to Section 400.23(8)(b), Fla. Stat. (2002), and Section 42 483.25 (c). The Agency also intends to impose a conditional rating effective December 6, 2002 through November 30, 2003, pursuant to Section 400.23(7), Fla. Stat. (2002) case no. 2003000114. JURISDICTION AND VENUE 2. This count has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes, (2002). 3. Venue lies in Leon County, Tallahassee, Florida, pursuant to Section 120.57, Florida, (2002), and Chapter 59A-4, Florida Administrative Code. PARTIES 4. AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing skilled nursing facilities pursuant to Chapter 400, Part Nl, Florida Statutes, (2002), and Chapter 59A-4 Florida Administrative Code. 5. Heritage Healthcare Center is a for-profit Florida corporation, whose 180-bed nursing home is located at 1815 Ginger Drive, Tallahassee, Florida. Heritage Healthcare Center is licensed as a skilled nursing facility license #SNF12210961; certification number 9622 effective December 6, 2002 through November 30, 2003. Heritage Healthcare Center was at all times material hereto, a licensed facility under the licensing authority of AHCA, and was required to comply with all applicable rules, and statutes. COUNT I HERITAGE HEALTHCARE CENTER FAILED TO ENSURE CONSISTENT CARE AND TREATMENT TO PREVENT INFECTION AND PROMOTE HEALING FOR 1 OF 4 SAMPLED RESIDENTS. (#2) FEDERAL TAG F314-Quality of Care 42 C.F.R. 483.25(c) 6. AHCA realleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. On or about December 6, 2002, AHCA conducted a complaint investigation at the Respondent’s facility. AHCA cited the Respondent based on the findings below, to wit: a.) During a complaint investigation on or about November 22, 2002, Heritage Health Care Center failed to ensure consistent care and treatment to prevent infection and promote healing for 1 of 4 sampled residents. (#2) 8. The above constitutes a violation of Section 42 C.F.R. 483.25(c), requiring that based on the comprehensive assessment of a resident, the facility must ensure that--- (1) A resident who enters the facility without pressure sores does not develop pressure unless the individual’s clinical condition demonstrates that they were unavoidable; and (2) A resident having pressure sores receives necessary treatment and services:to promote healing prevent infection and prevent new sores from developing. 9. The violation alleged herein constitutes a class II deficiency, and warrants a fine of $5,000. WHEREFORE, AHCA demands the following relief: 1. Enter factual and legal findings as set forth in the allegations of this administrative complaint. 2. Impose a fine in the amount of $5,000. The above also constitutes a violation of Section 400.23(8)}(b), Fla. Stat. (2002), providing that a class II deficiency is a deficiency that the agency determines has compromised the 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. A class II deficiency is subject to a civil penalty of $2,500 for an isolated deficiency, $5,000 for a patterned deficiency, and $7,500 for a widespread deficiency. The fine amount shall be doubled for each deficiency if the facility was previously cited for one or more class I or class II deficiencies during the last annual inspection or any inspection or complaint investigation since the last annual inspection. A fine shall be levied notwithstanding the correction of the deficiency. The above constitutes a violation of Section 400.23(7), Fla. Stat. (2002), requiring that the agency shall, at least every 15 months, evaluate all nursing home facilities and make a determination as to the degree of compliance by each licensee with the established rules adopted under this part as a basis for assigning a licensure status to that facility. The agency shall base its evaluation on the most recent inspection report, taking into consideration findings from other official reports, surveys, interviews, investigations, and inspections. The agency shall assign a licensure status of standard or conditional to each nursing home. Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.57, Fla. Stat. (2001). 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 the Agency for Health Care Administration, Building 3, MSC #3, 2727 Mahan Drive, Tallahassee, Florida, 32308; Michael O. Mathis, Senior Attorney. RESPONDENT IS FURTHER NOTIFED THAT THE FAILURE TO REQUEST A HEARING WITHIN 21 DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMINISTRATION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Respectfully submitted this a4, of a ee) 2003. SLAVAS NAC TANS Lae Michael O. Mathis Fla. Bar. No. 0325570 Counsel for Petitioner Agency for Health Care Administration Bldg. 3, MSC#3 2727 Mahan Drive Tallahassee, FL 32308 (850) 921-0055 (office) (850) 413-9313 (fax) Donah Heiberg Lealand McCharen Agency for Health Care Administration CERTIFICATE OF SERVICE I HEREBY CERTIFIY that a true and correct copy of the foregoing has been served by certified mail on [Eth day of tebr 2003 to: Lisa McGinley, Administrator, Heritage Health Care Center, 1815 Giner Drive, Tallahassee, Florida 32308. Davvero Rhy. Michael O. Mathis, Esq.

Docket for Case No: 03-001564