STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 7.5 LH.S. AT BRANDON, INC. d/b/a 1.HLS. AT BRANDON, LH.S. OF ORMOND BEACH, INC. d/b/a ORMOND IN THE PINES, LH.S. OF FLORIDA NO. 4, INC., d/b/a PALMS GARDEN OF LARGO, PALMS GARDEN OF JACKSONVILLE, LELS. OF FLORIDA NO. 6, INC, d/b/a PALM GARDEN OF OCALA, LIELS. OF FLORIDA NO. 2, INC. d/b/a PALM GARDEN OF GAINESVILLE, LHS. OF FLORIDA NO. 1. INC., d/b/a PALM GARDEN OF CLEARWATER, LHS. OF FLORIDA NO. 8, INC. d/b/a PALM GARDEN OF PINELLAS, LHS. OF FLORIDA NO. 10, INC. d/b/a PALM GARDEN OF SUN CITY, LH.S. OF FLORIDA NO. 11, INC. d/b/a PALM GARDEN OF TAMPA, LHS. OF FLORIDA NO. 14, INC. d/b/a PALM GARDEN OF WINTER HAVEN, LH.S. OF FLORIDA NO. 7, INC. d/b/a PALM GARDEN OF ORLANDO, 1.H.S. OF BRADEN RIVER, PALM GARDEN OF NORTH MIAMI BEACH, PALM GARDEN OF WEST PALM BEACH, PALM GARDEN OF PORT ST. LUCIE, Case No. 03-4754 MPT 24 A 8 14 Case No. 03-4725 MPI Case No. 03-4726 MPI. Case No. 03-4727 MPI Case No. 03-4728 MPI Case No. 03-4729 MPI Case No. 03-4730 MPI Case No. 03-4731 MPI Case No. 03-4732 MPI Case No. 03-4733 MPI Case No. 03-4734 MPI Case No. 03-4735 MPI Case No. 03-4736 MPI Case No. 03-4737 MPI Case No. 03-4738 MPI Case No. 03-4739 MPI Do C W5 LH.S. OF FLORIDA NO. 12, INC. d/b/a PALM GARDEN OF VERO BEACH Case No. 03-4740 MPI A 1LH.S. OF FLORIDA AT JACKSONVILLE, INC., My SEP . Case No. 03-4741 MEPL SEP 29 A & TI HHC-DAYTONA, Case No. 03-4742 MPI FLORIDA LIFE CARE, INC., d/b/a Case No. 04-0801 MPI = LH.S. OF VENICE NORTH, oer mt ay SO oon Petitioner, Case NOS. 03-4724MPI - < ia Through 03-4742MPI oe y. and 04-0801MPI- = STATE OF FLORIDA, AGENCY FOR JUDGE: DANIEL MANRY = HEALTH CARE ADMINISTRATION, o Respondent. / a FINAL ORDER THE PARTIES resolved all disputed issues and executed a settlement agreement which is attached and incorporated by reference. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is CLOSED. DONE AND ORDERED on this the _2@_ day of Stet tarde , 2004, in Tallahassee, Florida. Meteors Alan Levine, Secretary Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A SECOND COPY ALONG WITH FILING FEE AS PRESCRIBED BY LAW, WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT 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 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies Furnished to: Carol W. Disbro, Director of Reimbursement Integrated Health Services The Highlands 910 Ridgebrook Road Sparks, Maryland 21152 (U.S. Mail) Jeffries H. Duvall, Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (Interoffice) Lisa D. Milton, Administrator of Audit Services Medicaid Program Analysis 2727 Mahan Drive, MS #5 Tallahassee, Florida 32308 (Interoffice) Finance & Accounting Medicaid Accounts Receivables Agency for Health Care Administration 2727 Mahan Drive, MS #14 (Interoffice) Daniel Manry Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalchee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addresses by U.S. Mail on this the Z q day of ; 2004. 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS J.H.S. AT BRANDON, INC., d/b/a 1.H.S. AT BRANDON, 1.H.S. OF ORMOND BEACH, INC., d/b/a ORMOND IN THE PINES, J.H.S. OF FLORIDA NO. 4, INC., d/b/a PALM GARDEN OF LARGO, PALM GARDEN OF JACKSONVILLE, 1.H.S. OF FLORIDA NO. 6, INC., d/b/a PALM GARDEN OF OCALA, 1.H.S. OF FLORIDA NO. 2, INC., d/b/a PALM GARDEN OF GAINESVILLE, LH.S. OF FLORIDA NO. 1, INC., d/b/a PALM GARDEN OF CLEARWATER, 1.H.S. OF FLORIDA NO. 8, INC., d/b/a PALM GARDEN OF PINELLAS, J.H.S. OF FLORIDA NO. 10, INC., d/b/a PALM GARDEN OF SUN CITY, 1.H.S. OF FLORIDA NO. 11, INC., d/b/a PALM GARDEN OF TAMPA, J.H.S. OF FLORIDA NO. 14, INC., d/b/a PALM GARDEN OF WINTER HAVEN, 1.H.S. OF FLORIDA NO. 7, INC., d/b/a PALM GARDEN OF ORLANDO, LH.S. OF BRADEN RIVER, PALM GARDEN OF NORTH MIAMI BEACH, PALM GARDEN OF WEST PALM BEACH, PALM GARDEN OF PORT ST. LUCIE, Case no. : 03-4724 MPI Case No. : Case no. Case No. : Case No. : Case No. : Case No. : Case No. : Case No. : Case No. : Case No.: Case no.: Case No.: Case No.: Case No.: Case No.: 03-4725 MPI : 03-4726 MPI 03-4727 MPI 03-4728 MPI 03-4729 MPI 03-4730 MPI 03-4731 MPI 03-4732 MPI 03-4733 MPI 03-4734 MPI 03-4735 MPI 03-4736 MPI 03-4737 MPI 03-4738 MPI 03-4739 MPI - LHS. OF FLORIDA NO. 12, INC., d/b/a PALM Case No.: 03-4740 MPI GARDEN OF VERO BEACH, LH.S. OF FLORIDA AT JACKSONVILLE, INC., Case No.: 03-4741 MPI HHC - DAYTONA, Case No.: 03-4742 MPI FLORIDA LIFE CARE, INC., Case No.: 04-0801 MPI d/b/a LH.S. OF VENICE NORTH, Petitioners, vs. CASE NOS. 03-4724MPI through 03-4742MPI and 04-0801 MPI STATE OF FLORIDA, AGENCY FOR JUDGE: DANIEL MANRY HEALTH CARE ADMINISTRATION, Respondent. / SS ETTLEMENT AGREEMENT SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and 1.H.S. LONG TERM CARE, INC., a Delaware Corpor- ation, (as successor in interest to I.H.S. of Florida, Inc), d/b/a the above referenced entities, (“hereinafter Provider”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered into between the parties for the purpose of resolving ongoing litigation in the above referenced matters. 2. Provider is a Medicaid provider in the State of Florida, operating nursing homes that were audited by the Agency. 3. The Agency conducted audits of the Provider’s cost reports for the periods specified in paragraph 5 below. 4. In its Audit Reports issued on October 28, 2003, AHCA notified Provider that a review of the cost report revealed that, in its opinion, some claims in whole or in part were not reimbursable by Medicaid. The Agency further notified Provider of the adjustment which AHCA was making to the cost reports. In response to the Audit Reports, Provider filed timely petitions for a formal administrative hearing that was assigned DOAH Case Nos. 03-4724 through 03-4742 and Case No. 04-1801. 5. In its petition for administrative hearing, Provider identified specific adjustments that it appealed. 6. Subsequent to the request for administrative hearing, AHCA and Provider exchanged documents and discussed the adjustments that were at issue. As a result of the aforementioned exchanges, the parties agree that the Agency’s adjustments which were the subject of these proceedings, as they relate to the cost reports for the periods ending May 31, 1999, December 31, 1999, May 31, 2000, and December 31. 2000!, from the above referenced entities, (audit #s below), shall be resolved as follows: (a) LH.S. AT BRANDON (Audit #NH02-046S) Case No.: 03-4724 MPI 1. Audit Report cost AJE #1 to ‘General Liability Insurance’ in the amount of $(3,009) will be removed. 2. Audit Report cost AJE #7 to ‘Property Insurance’ in the amount of $(725) will be removed. 3. LH.S. Home Office cost adjustment AJE#4 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #8 to ‘Home Office Capital’ in the amount of $(10,399) to be reduced to $(8,379). (6) ORMOND IN THE PINES (NH02-047S) Case No.: 03-4725 MPI 1. Audit Report cost, AJE #7 to ‘Property Insurance’, in the amount of $(1,850), will be removed. (c) PALM GARDEN OF LARGO (NH02-048S) Case No.: 03-4726 MPI 1. LHS. Home Office cost adjustment AJE#6 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE ' The cost reports involved in this agreement were filed at different times as follows: May 31, 1999: HCC - Daytona December 31, 1999: Ormond in the Pines May 31, 2000: LHS. of Braden River December 31, 2000: All remaining entities. (d) (¢) #5 to ‘Home Office Capital’ in the amount of $(12,234) to be reduced to $(9,858).. PALM GARDEN OF JACKSONVILLE (NH02-049S) Case No.: 03-4727 MPI 1. LH.S. Home Office cost adjustment AJE#8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #5 to ‘Home Office Capital’ in the amount of $(9,787) to be reduced to $(7,886). PALM GARDEN OF OCALA (NH02-050S) Case No.: 03-4728 MPI 1. Audit Report cost reclassification adjustment, AJE #1, to ‘Plant Operations-rent equipment’ in the amount of $(105), will be removed. 2. Audit Report cost reclassification adjustment, AJE #2, to ‘Administration-rent equipment’ in the amount of $(23,991), will be reduced to$(4,032). 3. Audit Report cost reclassification adjustment, AJE #5, to ‘Allowable Ancillary- rent equipment’ in the amount of $625, will be removed. 4. Audit Report cost reclassification adjustment, AJE #6, to ‘Allowable Ancillary- rent equipment’ in the amount of $(73,621), will be changed to a positive adjustment of $1,255. 5. Audit Report cost reclassification adjustment, AJE #8, to ‘Patient Care-rent equipment’ in the amount of $(35,751), will be reduced to $(1,255). 6. Audit Report cost reclassification adjustment, AJE #9, to ‘Patient Care-rent equipment’ in the amount of $(672), will be removed. 7. Audit Report cost reclassification adjustment, AJE #10, reclassifying costs to ‘Property rent’, will be reduced from $133,515 to $4,032. 8. LHS. Home Office cost adjustment AJE#8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #11 to ‘Home Office Capital’ in the amount of $(13,763) to be reduced to $(11,090). 69) (g) PALM GARDEN OF GAINESVILLE (NH02-051S) Case No.: 03-4729 MPI 1. Audit Report cost reclassification adjustment, AJE #2, to ‘Administration-rent equipment’ in the amount of $(7,365), will be reduced to $(4,842). Audit Report cost reclassification adjustment, AJE #5, to ‘Allowable Ancillary- rent equipment’ in the amount of $(2,269), will be removed. Audit Report cost reclassification adjustment, AJE #7, to ‘Patient Care-rent equipment’ in the amount of $(53,934), will be reduced to $(2,938). Audit Report cost reclassification adjustment, AJE #8, to ‘Patient Care-rent equipment’ in the amount of $(89), will be removed. Audit Report cost reclassification adjustment, AJE #10, reclassifying costs to ‘Property rent’, will be reduced from $63,657 to $7,780. LHS. Home Office cost adjustment AJE#8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #11 to ‘Home Office Capital’ in the amount of $(10,399) to be reduced to $(8,379).. PALM GARDEN OF CLEARWATER (NH02-052S) Case No.: 03-4730 MPI 1. Audit Report cost reclassification adjustment, AJE #1, to ‘Plant Operations-rent equipment’ in the amount of $(616), will be reduced to $(589). Audit Report cost reclassification adjustment, AJE# 2, to ‘Administration-rent equipment’ in the amount of $(15,355), will be reduced to $(5,284). Audit Report cost reclassification adjustment, AJE #5, to ‘Allowable Ancillary- rent equipment’ in the amount of $(3,200), will be removed. Audit Report cost reclassification adjustment, AJE #6, to ‘Allowable Ancillary- rent equipment’ in the amount of $(241), will be removed. Audit Report cost reclassification adjustment, AJE #7, to ‘Allowable Ancillary- rent equipment’ in the amount of $(18,348), will be removed. Audit Report cost reclassification adjustment, AJE #10, to ‘Patient Care-rent equipment’ in the amount of $(3,661), will be removed. Audit Report cost reclassification adjustment, AJE #11, to ‘Patient Care-rent equipment’ in the amount of $(50,996), will be removed. Audit Report cost reclassification adjustment, AJE #14, reclassifying costs to ‘Property rent’, will be reduced from $92,417 to $5,873. LHS. Home Office cost adjustment AJE#8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #15 to ‘Home Office Capital’ in the amount of $(10,093) to be reduced to $(8,133). (h) PALM GARDEN OF PINELLAS (NH02-053S) Case No.: 03-4730 MPI 1. LH.S. Home Office cost adjustment AJE#8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #4 to ‘Home Office Capital’ in the amount of $(10,399) to be reduced to $(8,379). (i) PALM GARDEN OF SUN CITY (NHO02-054S) Case No.: 03-4732 MPI 1. Audit Report reclassification adjustment, AJE #1, to ‘Plant Operations-rent equipment’ in the amount of $(15), will be removed. Audit Report reclassification adjustment, AJE #3, to ‘Administration-rent equipment’ in the amount of $(426), will be removed. Audit Report cost reclassification adjustment, AJE #6, to ‘Allowable Ancillary- rent equipment’ in the amount of $(1,161), will be removed. Audit Report cost reclassification adjustment, AJE #7, to ‘Allowable Ancillary- rent equipment’ in the amount of $(5,951), will be removed. Audit Report cost reclassification adjustment, AJE #9, to ‘Patient Care-rent equipment’ in the amount of $(14,358), will be removed. Audit Report cost reclassification adjustment, AJE #10, to ‘Patient Care-rent equipment’ in the amount of $(1,441), will be removed. Audit Report cost reclassification adjustment, AJE #11, reclassifying costs to ‘Property-rent’ in the amount of $23,532, will be removed. LHS. Home Office cost adjustment AJE#8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE G) (k) #12 to ‘Home Office Capital’ in the amount of $(10,399) to be reduced to $(8,379). PALM GARDEN OF TAMPA (NH02-055S) Case No.: 03-4733 MPI 1. Audit Report cost reclassification adjustment, AJE #1, to ‘Plant Operations-rent equipment’ in the amount of $(15), will be removed. Audit Report cost reclassification adjustment, AJE #4, to ‘Administration-rent equipment’ in the amount of $(426), will be removed. Audit Report cost reclassification adjustment, AJE #7, to “Allowable Ancillary- rent equipment’ in the amount of $(1,161), will be removed. Audit Report cost reclassification adjustment, AJE #8, to ‘Allowable Ancillary- rent equipment’ in the amount of $(5,951), will be removed. Audit Report cost reclassification adjustment, AJE #10, to ‘Patient Care-rent equipment’ in the amount of $(14,538), will be removed. Audit Report cost reclassification adjustment, AJE #11, to ‘Patient Care-rent equipment’ in the amount of $(1,441), will be removed. Audit Report cost reclassification adjustment, AJE # 12, reclassifying costs to ‘Property-rent’ in the amount of $23,532, will be removed. LH.S. Home Office cost adjustment AJE #6 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #13 to ‘Home Office Capital’ in the amount of $(10,093) to be reduced to $(8,133). PALM GARDEN OF WINTER HAVEN (NH02-056S) Case No.: 03-4734 MPI 1. I.H.S. Home Office cost adjustment AJE #8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #5 to ‘Home Office Capital’ in the amount of $(9,481) to be reduced to $(7,640). Q) (m) (n) PALM GARDEN OF ORLANDO (NH02-057S) Case No.: 03-4735 MPI 1. LH.S. Home Office cost adjustment AJE #6 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #6 to ‘Home Office Capital’ in the amount of $(8,870) to be reduced to $(7,147). IHS BRADEN RIVER (NH02-058S) Case No.: 03-4736 MPI 1. LH.S. Home Office cost adjustment AJE #8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #5 to ‘Home Office Capital’ in the amount of $(4,078) to be reduced to $(3,286). PALM GARDEN OF NORTH MIAMI BEACH (NH02-059S) Case No.: 03-4737 MPI 1. Audit Report cost reclassification adjustment, AJE #1, to ‘Administration-rent equipment’ in the amount of $(8,723), will be reduced to $(8,321) 2. Audit Report cost reclassification adjustment, AJE #4, to ‘Allowable Ancillary — rent equipment’ in the amount of $(575), will be removed. 3. Audit Report cost reclassification adjustment, AJE #5, to ‘Allowable Ancillary — rent equipment’ in the amount of $(22,392), will be removed. 4. Audit Report cost reclassification adjustment, AJE #7, to ‘Nursing ~ rent equipment’ in the amount of $(16,321), will be removed. 5. Audit Report cost reclassification adjustment, AJE #8, to ‘Nursing — rent equipment’ in the amount of $(13,300), will be removed. 6. Audit Report cost reclassification adjustment, AJE #10, reclassifying costs to ‘Property — rent’, will be reduced from $61,311 to $8,321. 7. LH.S. Home Office cost adjustment AJE #6 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #11 to ‘Home Office Capital’ in the amount of $(9,481) to be reduced to $(7,640). (0) (p) PALM GARDEN OF WEST PALM BEACH (NH02-0608) Case No.: 03-4738 MPI 1. Audit Report cost reclassification adjustment, AJE #1, to “Administration-rent equipment’ in the amount of $(15,692), will be reduced to $(11,445). 2. Audit Report cost reclassification adjustment, AJE #4, to ‘Allowable Ancillary- rent equipment’ in the amount of $(1,807), will be changed to a positive adjustment of $746. 3. Audit Report cost reclassification adjustment, AJE #5, to “Allowable Ancillary- rent equipment? in the amount of $(2,504), will be removed. 4. Audit Report cost reclassification adjustment, AJE #6, to ‘Allowable Ancillary- rent equipment’ in the amount of $(38,921), will be changed to a positive adjustment of $1,200. 5. Audit Report cost reclassification adjustment, AJE #10, to “Patient Care-rent equipment’ in the amount of $(11,091), will be reduced to $(746). 6. Audit Report cost reclassification adjustment, AJE #11, to ‘Patient Care-rent equipment’ in the amount of $(31,306), will be reduced to $(1,200). 7. Audit Report cost reclassification adjustment, AJE #12, reclassifying costs to ‘Property rent’, will be reduced from $101,321 to $11,445. 8. LH.S. Home Office cost adjustment AJE #8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #13 to ‘Home Office Capital’ in the amount of $(14,986) to be reduced to $(12,076). PALM GARDEN OF PORT ST. LUCIE (NH02-061S) Case No.: 03-4739 MPI 1. Audit Report cost reclassification adjustment, AJE #1, to ‘Administration-rent equipment’ in the amount of $(5,486), will be reduced to $(1,072). 2. Audit Report cost reclassification adjustment, AJE #4, to ‘Allowable Ancillary- rent equipment’ in the amount of $(1,690), will be removed. 3. Audit Report cost reclassification adjustment, AJE #5, to ‘Allowable Ancillary- rent equipment’ in the amount of $(564), will be removed. 4. Audit Report cost reclassification adjustment, AJE #6, to ‘Allowable Ancillary- rent equipment’ in the amount of $(21,222), will be removed. (q) () 5. Audit Report cost reclassification adjustment, AJE #8, to ‘Patient Care-rent equipment’ in the amount of $(3,810), will be reduced to $(1,235). 6. Audit Report cost reclassification adjustment, AJE #9, to ‘Patient Care-rent equipment’ in the amount of $(26,805), will be removed. 7. Audit Report cost reclassification adjustment, AJE #11, to ‘Patient Care-rent equipment’ in the amount of $(2,494), will be removed. 8. Audit Report cost reclassification adjustment, AJE #12, reclassifying costs to ‘Property rent’, will be reduced from $62,071 to $2,307. 9. 1.H.S. Home Office cost adjustment AJE#8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #15 to ‘Home Office Capital’ in the amount of $(9,481) to be reduced to $(7,640). PALM GARDEN OF VERO BEACH (NH02-062S) Case No.: 03-4740 MPI 1. LH.S. Home Office cost adjustment AJE #8 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #5 to ‘Home Office Capital’ in the amount of $(12,846) to be reduced to $(10,351). IHS of FLORIDA AT JACKSONVILLE (NH02-063S) Case No.: 03-4741 MPI 1. Audit Report cost reclassification adjustment AJE #2 to ‘Administration — rent equipment’ in the amount of $(17,459) will be removed. 2. Audit Report cost reclassification adjustment AJE #4 to ‘Allowable Ancillary — rent equipment’ in the amount of $(420) will be removed. 3. Audit Report cost reclassification adjustment AJE #5 to ‘Allowable Ancillary — rent equipment’ in the amount of $(14,951) will be removed. 4. Audit Report cost reclassification adjustment, AJE #9, reclassifying costs to ‘Property-rent’, will be reduced from $40,609 to $7,779. 5. Audit Report cost AJE #8 to ‘Property Insurance’, in the amount of $(1,486), will be removed. 10 6. LH.S. Home Office cost adjustment AJE #4 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #11 to ‘Home Office Capital’ in the amount of $(9,481) to be reduced to $(7,640). (s) WHC - DAYTONA (NH02-064S) Case No.: 03-4742 MPI 1. Audit Report cost, AJE’s #’s 2, 3, 4, 7, 8, 9, 10, 11, 12, 13 and 15 to Employee Benefits-various cost centers, in the total amount of $(34,642), will be removed. . 2. Audit Report cost, AJE #16 to ‘Property Insurance’, in the amount of $(2,585), will be removed. (t) LH.S. OF VENICE NORTH (NH03-091S) Case no.: 04-0801 MPI 1. 1.H.S. Home Office cost adjustment AJE#4 to Amortization expense, in the amount of $(594,000), will be removed and will cause Audit Report cost AJE #7 to ‘Home Office Capital’ in the amount of $(12,540) to be reduced to $(10,104). 7. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree that the adjustment resolution, as set forth above, will resolve and settle this case completely. As such, by this agreement constitutes Provider’s withdrawal of the petition for administrative hearing, with prejudice. 8. Provider and AHCA further agree that the Agency shall recalculate the per diem rate for these time periods, and issue a notice of the recalculation. Where Provider was overpaid, Provider will remit payment to the Agency in the full amount of the cost within thirty (30) days of such notice. Where Provider was underpaid, AHCA will remit payment to the Provider in the full amount of the underpayment within forty-five (45) days of such notice. 9. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 11 And payment shall clearly indicate that it is per a settlement agreement, shall reference the DOAH Case Number, and shall reference the audit number. 10. Provider agrees that failure to pay any monies due and owing under the terms of this Agreement shall constitute Provider’s authorization for the Agency, without further notice, to withhold the total remaining amount due under the terms of this agreement from any monies due and owing to Provider for any Medicaid claims. 11. Provider and AHCA reserve the right to enforce this Agreement under the laws of the State of Florida, the Rules of the Medicaid Program, and all other applicable rules. 12. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. However, the parties believe that this matter should be settled because the parties have agreed to the terms contained within this agreement. 13. Each party shall bear its own attorneys’ fees and costs, if any. 14. The signatories to this Agreement, acting in a representative capacity, represent that they are duly authorized to enter into this Agreement on behalf of the respective parties. The parties further agree that a facsimile or photocopy reproduction of this agreement shall be sufficient for the parties to enforce the agreement and to cancel the hearing in this matter. Provider agrees, however, to forward a copy of this agreement to AHCA with original signatures, and understands that a Final Order may not be issued until said agreement is received by AHCA. 15. This Agreement shall be construed in accordance with the provisions of the laws of Florida. Venue for any action arising from this Agreement shall be in Leon County, Florida. 16. This Agreement constitutes the entire agreement between Provider and the AHCA, including anyone acting for, associated with or employed by them, concerning all matters and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between Provider and the AHCA other than as set forth herein. No modification or waiver of any provision shall be valid unless a written amendment to the Agreement is completed and properly executed by the parties. 17. This is an Agreement of settlement and compromise, made in recognition that the parties may have different or incorrect understandings, information and contentions, as to facts and law, and with each party compromising and settling any potential correctness or incorrectness of its 12