STATE OF FLORIDA ify AGENCY FOR HEALTH CARE ADMsTRAO iAY lg 9 GENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, Vs. Case No. 2003002132 02% 184 Continuum Care Services, Inc. d/b/a/ The Family, Respondent. / eel ADMINISTRATIVE COMPLAINT COMES NOW the AGENCY FOR HEALTH CARE ADMINISTRATION (nereinafter “Agency”), by and through the undersigned counsel, and files this Administrative Complaint against Continuum Care Services, Inc., d/b/a The Family (hereinafter “Respondent”), pursuant to Section 120.569, and 120.57, Florida Statutes, (2002), and alleges: NATURE OF THE ACTION 1. This is an action to impose a administrative fine pursuant to Rule 59E- 3.024(3)(a) and (5), and 59E-2.025(1)(a), Fia. Admin. Code, and Section 408.08(2) Florida Statutes, (2002) and as a result of a violations of Section 408.061(4)(a), Florida Statutes, (2002) and Rule 59E-5.201, Fla. Admin. Code. JURISDICTION 2. The Agency has jurisdiction over licensure and fines of the hospital pursuant to Chapter 395, Florida Statutes, (2002) and Chapter 59A-3, Fla. Admin. Code. 3%: LETEBLEPSE «=» -BSIGE EAALTHS OG NENUE 3, Venue shall be determined pursuant to Rule 28-106.207, Fia. Admin. Code, PARTIES 4. The Agency is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing hospitals pursuant to Chapter 35, Florida Statutes, (2002), and Chapter 59A-3 Fla. Admin. Code. 5. The Agency is the regulatory authority responsible for collecting and enforcing the hospital reporting requirements as required in Chapter 408, Florida Statutes, (2002), and Chapter 59A-3 Fla. Admin. Code. 6. Respondent is licensed as a hospital pursuant to Section 395.002(13), Fiorida Statutes. COUNT I RESPONDENT FAILED TO FILE A COMPLETE AND/OR ACCURATE PRIOR YEAR REPORT IN A TIMELY MANNER VIOLATING. § 408.061(4)(a), F.S. AND RULE 59E-5.201 and 59E-2.024(5), F.A.C. 7. The Agency realleges and incorporates by reference paragraphs (1) through (6) as if fully set forth herein. 8. The Respondent failed to submit a complete and accurate 2002 Prior Year Report for its fiscal year ending February 22, 2002; within 120 days subsequent to the snd of the facilities fiscal year pursuant to Section 408.061(4){a), Florida Statutes and Rule 59E-5.201, Fla. Admin. Code. 9. The Respondent’s original due date was June 22, 2002. one z ~ ESAS EBS PZ be Lzteqlerse ~ eS1ee Eeazrpa ree i6. The Agency senta notice of violation dated July 25, 2002, to the Respondent which specified the corrections needed to bring the hospitals report into compliance with statutory and rule requirements, allowed ten (10) working days to provide the Agency with the requested information, and gave notice that Respondent would be subject to imposition of an administrative fine if the requested information was not timely filed pursuant to Rule 59E-2.024(5), Fila. Admin. Code, Violation of Chapter 408 Florida Statutes or Board Rules, which states in part: (5) Prior to seeking to impose an administrative fine against an entity for the Violations described ... the Agency will send a notice of violation to the entity by certified mail, return receipt requested. If the entity corrects the violation within 10 working days of receipt of the notice, no violation will be deemed to have occurred and no administrative fine will be sought or imposed. If the entity does not correct the violation within that time, it shall be subject to imposition of an administrative fine which will be calculated from the original due date of the report or document. 11. The Respondent received the notice of violation, but failed to record a date cn the Certificate of Receipt. 12. Acopy of the notice of violation is attached hereto as Exhibit “A” and incorporated herein by reference. 13. The Agency sent a second notice informing the Respondent of delinquent ling on January 15, 2003. 14. Asigned Certified Mail Receipt confirms that the facility received the January 18, 2003 letter. 15, The Respondent failed to provide the Agency with the requested enformation specified in the July 25, 2002, notice of violation within ten (10) working days of the January 18, 2003 receipt of the second notice. 16. Acopy of the second notice is attached hereto as Exhibit “B”. pO ge TELE estes SBbtipZ/ro LETEQLERSE BSG 8BGL/bz/ Po Sa 3% 17. Failure to provide an accurate and/or complete Prior Year Report in a timely manner is a violation of Section 408.061(4)(a), Florida Statutes, and Rule 59E- 5,201, Fla. Admin. Code, which requires Respondent to file the Prior Year Report with the Agency within 120 days subsequent to the end of its fiscal year. 18. As of the date of this Administrative Complaint, April 14, 2003, Respondent has failed to appropriately file the report, resulting in a total of 297 days late, calculated pursuant to Rule 59E-2.024(5), Fla. Adm. Code from the original due date of June 22, 2002. 19. Section 408.08(2), Florida Statutes, provides that any hospital which refuses to file a report, fails to timely file a report, files a false report, or files an incomplete report shall be punished by a fine not to exceed $1,000 per day for each day ix, violation, to be fixed, imposed, and collected by the Agency. Each day in violation saall be considered a separate offense. 20. Respondent's violations constitute a Third Occurrence as defined in Rule 89B-2.025(1)(a), Fla. Admin. Code, which results in fine of $100.00 per day starting on the original filing due date of June 22, 2002. This violation constitutes the grounds for which the Agency imposes a fine in the minimum amount of $29,700.00 as of the date of tais Administrative Complaint pursuant to Sections Rule 59E-2.025 (1)(a), Fla. Admin. Code. 21, The Agency may impose additional fines due to continued failure to provide the report pursuant to Rule 59E-2.025 (1)(a), Fle. Admin. Code. Bach additional day is and additional violation and may be added to the total fine until the report is submitted pursuant to Rule 59E-2.025(1)(a) Fle. Adm. Code and Rule 59E-2.024(5), ee LZTEQAEPSE @Si@Z E882 p2.va CLAIM FOR RELIEF WHEREFORE, State of Florida, Agency for Health Care Administration requests the Court to order the following relief against the Respondent for continued violation of Section 408.061(4)(a), Florida Statutes, (2002) and Rule 59E-5.201, Fla. Admin. Code. pursuant to Rule 59E-2.024(3 (a) and (5), and 59E-2.025(1)(a), Fla, Admin. Code, and Section 408.08(2) Florida Statutes, (2002) finding: (A) Make factual and legal findings in favor of the Agency on Counts 1; (B) Recommend administrative fines and fees to be imposed against the Respondent as follows: 1, In the minimum amount of $29,700.00 and 2. Additional fines due to continued failure to file the 2002 Prior Year Report for its fiscal year ending February 22, 2002 as provided in Rule 59E-2.025(1){a), Fla. Admin. Code; and (C) All other general and equitable relief allowed by law. Respondent is notified that it has a right to request an administrative hearing pursuant to Geetion 120,569, Florida Statutes (2002). 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, Ursula Eikman, Staff Attorney, Building 3, MSC #3, 272 7 Mahan Drive, Tallahassee, Florida, 32308; RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST A HEARING WITHIN 21 DAYS OF RECEIPT OF THIS 9G BSN pee Ee éZTEBLEDSE @S:82 CBBZ/ PZ / pu £8 COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. Dated on this 14" day of April 2003. Respectfully submitted, ae Eikman, Esquire Assistant General Counsel Florida Bar [.D. 0500941 Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308 (850) 922-5873 (office) CERTIFICATE OF SERVICE J HEREBY CERTIFY that a true and correct copy of the foregoing has been served by U. S. certified mail/retum receipt requested on April 14, 2003 10 Sunrise Fegional Medical Center, 555 S.W. 148" Avenue, Sunrise, Florida 33325: Urs ikman, Esq. WE/sr BV LTTEGLEPSE @S +@z EBGC PZ PB FLORIDA AGENCY FOR HEATH CARE ADMINSTRATION JEB BUSH, GOVERNOR : RHONDA MpMEDGMY ERTIFIED MAIL i iat a July 25, 2002 ADMILIS FRa WE Burt Munoz Chief Executive Officer Sunrise Regional Medical Center 555 S.W. 148" Avenue Sunrise. FL 33325 RE: 2002 Prior Year Report, FYE: 2/22/02 Hospital Number — 110035 Deemed-not-Filed Notice of Violation Dear Mz, Munoz: Pursuant to rule 59E-2.024, 59E-5.103, 59E-5.204 and 59E-5,206 F.A.C., the above referenced report has been found incomplete and deemed not filed for the following reason(s): ow Prior Year Actual Report Pursuant to rule 59E-5.201 and 59E-5.206 F.A.C., your hospital is required to submit to the Agency its actual report in electronic format. Please submit (1) 3.5 inch diskette pursuant to the formatting requirements provided in Rule 59E-5.206. nA Audited financial statements Pursuant to rule 59E-5.201 F.A.C., your hospital is required to submit the hospital’s audited financial statements. Please submit (1) copy of the audited financia! statements. Draft copies are not accepted. Oo Medicare Cost Report Pursuant to mile 59E-5.201 F.A.C., your hospital is required to submit (1) copy of the Medicare Cost Report. Please submit (1) copy of the Medicare Cost Report. Visit AHCA online at www fdhe.state flus 2727 Mohan Drive « Mall Stop #268 Tallahassee. FL 32505 TT 35% bie oe —— LTTEGZEDSE AGIAZ FART /b7 for 7 a) is your RETURN ADDRESS completed on the reverse side? a ‘ sj dO W3ANF 30 dot sv HANDS GOVT SENDER: O Gomplete hems 4 and/or 2 [or addilional services. Compiate heme 3. 44, and 4b. Print your name and eddrese on the reverse of this form 80 Mal we can return thie card loyou. B Anach this form to the front of the malipieca, of on the back if space does not permit Dr Write "Ristum Aeoeipt Requestac” on the mailpiece beiow the aflicle number. DThe Aetum Receipt will anow to whom the anicis was delivered and ine date dwlivered, I Sunred Pegionel 4b, Service Type O Registered 2. Anicie Addressed lo: 4a, Article Number | also wish to receive the tollow- ing services (for an extra fae): 1, D Addresaee's Adtrass 2. 1 Restricted Delivery Eicenties © Express Mail insured © Retum Recelp! tor Merchandise (] COD 7, Date of Delivery ae % 5, Received By: (Print Nama) fee is paid) oat) PS Form 3871, December is66 1QAbeS-99-5-022: &, Addressee's Adaress (Only if raquested and LTTEBLEDSS GS‘°OZ SAA? Mp7 foo : = y i 6 gg ~ Bae Bad RHON! MEDOWS, MO, FAAFP, SECRETARY #88 BUSH, GOVERNOR ERTIFIED MAIL PTS ew 1. : HIG January 15, 2003 * Uy; , ADMIN [Se op thes i A yt Burt Munoz HEA RINGS we Chief Executive Officer Sunrise Regional Medical Center 555 SW, 148" Avenue Sunrise, Florida 33325 RE: 2002 Prior Year Report FYE: 02 AHCA#: 1]-0035 Dear Mr. Munoz: Please be advised that the Agency has not received the above referenced report which was due in our office June 22, 2002. On July 25, 2002 you were notified by certified letter of the hospital’s noncompliance with this filing requirement and our certified mail receipt indicates you received the notice. Rule 59E-2.024 ofthe Florida Administrative Code allows the hospital 10 working | days after the receipt of the notice to file the delinquent report. Section 408.08 of the Florida Statues provides that any hospital which refuses to file or fails to file @ report when required by the Agency, shall be punished by a fine not to exceed $1,000 per day for each day it is late. Unless you respond immediately, this office will file an administrative complaint against the facility in order to gain your compliance. You may contact Paul Kennedy at (850) 922-7434 to receive assistance in resolving this issue. Sincergly, f ) i \ns ristopher J. Augsburger Regulatory Analyst Supervisor Vistt ARCA online at 2727 Mahan Drive © Mail Stop #1 www fdhe.siateflus Talinhassec, FL 32308 PL 2o¥e ZTE LETEQLEPSE -BSIBZ -SBBL/ Pz pa ST isnt WweRri ww COMPLFTE THIS SECTION ON DELIVERY # Complete Items 1, 2, and 3. Also complete itam 4 Ht Restricted Delivery Is desired, ® Print your name and address on the reverse delivery BadroEs different from D 1 YES, enter dativery address beiow, CINo 1. Article Addressed to: Shan ian Regione! vice Type 3. rs Certitted Mail = Express Mali CO Ragistered (0 Return Receipt for Merchandise D ineured Mail c.0.0. “ Yee 2, Amicis Number (Copy fram yervics PS Form 3811, July 1989 Domestic Return Receipt 102685-00-M-0952 LZ1EGIEPSE «BS 182 EQBZ/b7./ en

Docket for Case No: 03-001841