Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: PINEHURST HEALTH CARE ASSOCIATES, LLC, D/B/A SEAVIEW NURSING AND REHABILITATION CENTER
Judges: ERROL H. POWELL
Agency: Agency for Health Care Administration
Locations: Fort Lauderdale, Florida
Filed: Apr. 08, 2004
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Thursday, July 15, 2004.
Latest Update: Dec. 23, 2024
STATE OF FLORIDA Ack Le Dt
AGENCY FOR HEALTH CARE ADMINISTRA al CPi kt 10
AGENCY FOR HEALTH CARE nih
ADMINISTRATION,
Petitioner, AHCA No.: 2004000723
AHCA No.: 2004000161
v. Return Receipt Requested:
7002 2410 0001 4237 0188
PINEHURST HEALTH CARE ASSOCIATES, 7002 2410 0001 4237 0195
LLC, d/b/a SEAVIEW NURSING AND 7002 2410 0001 4237 0201
REHABILITATION CENTER,
Respondent.
ADMINISTRATIVE COMPLAINT
COMES NOW the Agency for Health Care Administration
(hereinafter referred to as “AHCA”), by and through the
undersigned counsel, and files this Administrative
Complaint against Pinehurst Health Care Associates, LLC,
d/b/a Seaview Nursing and Rehabilitation Center “Seaview
Nursing and Rehabilitation Center”), pursuant to Chapter
400, Part II, and Section 120.60, Fla. Stat. (2002), and
alleges:
NATURE OF THE ACTIONS
1. This is an action to impose an administrative
fine of $1,000.00 pursuant to Section 400.23(8), Fla. Stat.
(2002), for the protection of the public health, safety and
welfare.
2. This is an action to impose a Conditional
Licensure status to Seaview Nursing and Rehabilitation
Center, pursuant to Section 400.23(7)(c), Fla. Stat (2002).
JURISDICTION AND VENUE
3. This Court has jurisdiction pursuant to Sections
120.569 and 120.57, Fla. Stat. (2002), and Chapter 28-106,
F.A.C.
4. Venue lies in Broward County, pursuant to Section
400.121(1) (e), Fla. Stat. (2002), and Rule 28-106.207,
Florida Administrative Code.
PARTIES
5. AHCA is the regulatory authority responsible for
licensure and enforcement of all applicable statutes and
rules governing nursing homes, pursuant to Chapter 400,
Part II, Fla. Stat., (2002), and Chapter 59A-4 Florida
Administrative Code.
6. Seaview Nursing and Rehabilitation Center is an
83-bed skilled nursing facility located at 2401 N.E. Qn
Street, Pompano Beach, Florida 33062. Seaview Nursing and
Rehabilitation Center is licensed as a skilled nursing
facility; license number SNF1441096 certificate number
11150, effective 12/17/2003 through 11/30/2004. Seaview
Nursing and Rehabilitation Center was at all times material
hereto a licensed facility under the licensing authority of
AHCA and was required to comply with ali applicable rules
and statutes.
7. Because Seaview Nursing and Rehabilitation Center
participates in Title XVIII or XIX, it must follow the
certification rules and regulations found in Title 42
C.F.R. 483, as incorporated by Rule 59A-4.1288, F.A.C.
COUNT I
SEAVIEW NURSING AND REHABILITATION CENTER FAILED TO ENSURE
THAT ALL RESIDENTS WERE FREE FROM SIGNIFICANT MEDICATION
ERRORS
TITLE 42, SECTION 483.25(m) (2), Code of Federal
Regulations, incorporated by Rule 59A-4.1288, F.A.C.
(QUALITY OF CARE)
UNCORRECTED CLASS III DEFICIENCY
8. AHCA re-alleges and incorporates paragraphs (1)
through (7) as if fully set forth herein.
9. During standard survey conducted 11/12-14/2003
and based on interview and record review, it was determined
that the facility did not ensure that 2 of 17 sampled
residents (#9 and #7) were free from significant medication
errors. Resident #9 did not receive an anti-hypertensive
medication for approximately four months. Resident #7 did
not receive a psychoactive medication according £o
physician's orders for 12 days. The medication errors noted
For both residents were determined to be significant based
on the frequency of error. The findings include:
we
(a) During the reconciliation of the Medication
Administration observation at 11:00AM on 11/12/2003 on the
first floor nursing unit, it was determined through record
review that Resident #9 had admission diagnoses of
Hypertension, Organic Brain Syndrome, Non-psychotic Brain
Syndrome, Anemia, Esophageal Reflux Disease, Neurosyphilis
and Hypertension.
(b) Original admission orders of 12/07/2002
contained an order for "Atenolol Tabs. 25mg 1 tab. via G-
tube qi2 hrs. Hold for HR <60 or SPB <100". (HR = Heart
Rate, SBP=Systolic Blood Pressure) During the Medication
Administration Observation at 10:00AM on 11/12/2003, it was
noted that the SBP and HR were taken and recorded but the
medication "Atenolol" was not administered. Atenolol is a
medication to control blood pressure
(c) The reconciliation clinical record review on
11/13/2003, revealed an entry in the Medication
Administration Record (MAR) for July 2003, indicating
"D/C'd 7/3/03 in the column for Atenolol administration.
The MARs for August, September October and November were
reviewed and noted not to contain the order for Atenolol.
Further review of the clinical record for Resident #9 could
not determine that the medication had been discontinued by
the physician.
(a) Interview with the first floor Unit Manager
on 11/12 and 11/13 could not ascertain the reason why the
medication (Atenolol) was not administered as ordered from
7/03/2003 through 11/12/2003. The Unit Manager contacted
the physician by telephone on 11/12/2003 in an attempt to
verify the order to discontinue Atenolol. The physician
stated that he would have to review the clinical record to
assure that an order to discontinue the medication was
written. Subsequent to the phone call, the Unit Manager
wrote a telephone order dated 11/12/2003 "Clarification
order of 7/03/2003 D/C Atenolol 25mg via PEG BID qi2h. D/C
B/P + Pulse Atenolol". In interview with the Unit manager
on 11/12/2003 she confirmed that there was no order from
the physician to discontinue the Atenolol on 7/03/2003 or
anytime thereafter. Review of the November Medication
Administration Record for this resident for the period from
November 1st through the morning of November 13th revealed
that the heart rate was over 60 each day and the systolic
blood pressure was over 100 each day.
(e) On 11/13/2003, an order was written by the
physician to; (1) “decrease B/P and HR to once per week.
(2) Atenolol 25 mg via PEG B.I.D." Interview with the
Director of Nursing and the first floor Unit Manager on
11/12-13/2003 revealed that the medication Atenolol was not
wn
administered from 7/3/2003 to 11/12/2003. No reason for the
discontinuance could be elicited.
10. The clinical record for Resident's #7, include
the following in the list of diagnoses for the resident:
"Affective Psychosis." A physician's note dated 10/10/2003
for "Psychiatric follow-up and for medication and
behavioral management" was noted in the record. The note
documents the following: ".... continue with her angry
attitude and still paranoid.. no side effect noted or
reported. Plan, Increase Seroquel to 100 mg twice a day and
200 mg at hour of sleep." A review of the clinical record
for Resident #7 revealed a medication order dated
10/10/2003 for "Seroquel 100 mg twice a day and 200 mg at
hour of sleep." Review of the Medication Administration
Record for November 2003 on 11/13/2003 did not reveal
documentation that the medication was administered as
ordered for any day of the month. Interview with a staff
nurse on 11/13/2003 at 10:42 aM, revealed that the
medication increase was not carried over to the November
MAR. As a result, the medication was administered only
twice a day and did not have an entry for the dosage due at
hour of sleep for the 12 days of November. Correction Date:
12/14/2003.
11. During the revisit conducted on 12/17/2003 and
based on interview, and record review, on 12/17/2003, it
was determined that the facility still did not ensure that
1 of 9 sampled residents (#2) was free of a significant
medication error. Resident #2 did not receive 2
medications (an antipsychotic and antidepressant) for 17
days. This was determined to be significant based on the
frequency of error. The findings include:
(a) Review of the clinical record for Resident
#2 revealed an admission date of 11/18/2003. Diagnoses
documented for the resident included the following:
Fracture of the lower limb, Diabetes Mellitus, and
Dementia.
(b) Reconciliation of the December 2003
Medication Administration Record (MAR) with the current
medication orders for Resident #2 revealed two medications
were not documented on the MAR and there was no evidence
they had been administered in the month of December. A
physician's order dated 11/24/2003 specified the following:
Seroquel 25 mg one by mouth twice a day for Psychosis.
Lexapro 10 mg one by mouth every morning for depression.
No order was noted for the discontinuance of this
medication.
{c) A psych consult dated 11/24/2003 documents
the following: "According to staff, patient is combative
and responding to internal stimuli..... Diagnosis: Organic
Affective Disorder with psychosis and depression."
(ad) During interview on 12/18/2003 at 11:30 AM
and 12:15 PM with the staff nurse assigned to the resident,
he/she could not provide evidence that the medications
Seroquel and Lexapro were administered as ordered. This
information was brought to the attention of the
Administrator, Director of Nursing, and Corporate Nurse
Consultant, who after a review of the record could not
provide evidence to substantiate the medications were
administered as ordered prior to the end of the survey.
This is an uncorrected deficiency for the 11/12-14/2003
survey.
12. Based on the foregoing, Seaview Nursing and
Rehabilitation Center violated Title 42, Section
483.25(m) (2) Code of Federal Regulations as incorporated by
Rule 59A-4.1288, herein classified as an uncorrected Class
III deficiency pursuant to Section 400.23(8)(c), Fla.
Stat., which carries, in this case, an assessed fine of
$1,000.00 This violation also gives rise to a conditional
licensure status pursuant to Section 400.23(7) (b).
DISPLAY OF LICENSE
Pursuant to Section 400.23(7)(e), Florida Statutes,
Seaview Nursing 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.
The Conditional License is attached hereto as Exhibit
wan
CLAIM FOR RELIEF
WHEREFORE, the Petitioner, State of Florida Agency for
Health Care Administration requests the following relief:
A. Make factual and legal findings in favor of
the Agency on Count I
B. Assess an administrative fine of $1,000.00
against Seaview Nursing and Rehabilitation Center on Count
Tr.
Cc. Assess and assign a conditional license
status to Seaview Nursing and Rehabilitation Center in
accordance with Section 400.23(7) (b), Florida Statutes.
D. Grant such other relief as this Court deems
is just and proper.
Respondent is notified that it has a right to request an
administrative hearing pursuant to Sections 120.569 and
120.57, Florida Statutes (2002). Specific options for
administrative action are set out in the attached Election
of Rights and explained in the attached Explanation of
Rights. All requests for hearing shall be made to the
Agency for Health Care Administration, and delivered to the
Agency for Health Care Administration, 2727 Mahan Drive,
Building 3, Mail Stop #3, Tallahassee, Florida 32308,
attention Lealand McCharen, Agency Clerk. Telephone (850)
922-5873.
RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE
A REQUEST FOR 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.
Margargt Jfljz Lig
Assistant neral Counsel
Agency for Health Care
Administration
Spokane Building, Suite 103
8350 N.W. 52°? Terrace
Miami, Florida 33166
Copies furnished to:
Diane Reiland
Field Office Manager
Agency for Health Care Administration
1710 East Tiffany Drove, Suite 100
West Palm Beach, Florida 33407
(U.S. Mail)
10
Jean Lombardi
Finance and Accounting
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #14
Tallahassee, Florida 32308
(Interoffice Mail)
Skilled Nursing Facility Unit Program
Agency for Health Care Administration
2727 Mahan Drive
Tallahassee, Florida 32308
(Interoffice Mail)
11
EXHIBIT “A”
Conditional License
License No. SNF1441096 Certificate No.
Effective date: 12/17/2003
Expiration date: 11/30/2004
12
11150
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the
foregoing has been furnished U.S. Certified Mail, Return
Receipt Requested to Everton M. Spencer, Sr.,
Administrator, Seaview Nursing and Rehabilitation Center,
2401 N.E. 2-4 Street, Pompano Beach, Florida 33062;
Pinehurst Health Care Associates, LLC, 10210 Highland Manor
Drive, Suite 410, Tampa, Florida 3361; and to C.T.
Corporation System, 1200 South Pine Island Road,
Plantation, Florida 33324, on Fxb& Qb. , 2004,
-. LIGENSE #: SNF1441096
Of APR -8 PHU: 16
State of Florida ,;;,
AGENCY FOR HEALTH CARE ADMINISTRATION
DIVISION OF HEALTH QUALITY ASSURANCE
SKILLED NURSING FACILITY
CONDITIONAL
CERTIFICATE #: 11150
This is to confirm that PINEHURST HEALTH CARE ASSOCIATES, LLC has complied with the rules and regulations adopted by
the State of Florida, Agency For Health Care Administration, authorized in Chapter 400, Part II, Florida Statutes, and as the licensee is
authorized to operate the following:
SEAVIEW NURSING AND REHABILITATION CENTER
2401 N.E. 2ND STREET
POMPANO BEACH, FL 33062
TOTAL: 83 BEDS
ISSUED
ACTION EFFECTIVE DATE: 12/17/2003
LICENSE EXPIRATION DATE: 11/30/2004
Docket for Case No: 04-001192
Issue Date |
Proceedings |
Dec. 10, 2004 |
Final Order filed.
|
Jul. 15, 2004 |
Order Closing File. CASE CLOSED.
|
Jul. 14, 2004 |
Joint Motion for Abeyance (filed via facsimile).
|
Jun. 30, 2004 |
Order Granting Qualified Representative Status (to R. Davis Thomas, Jr).
|
Jun. 28, 2004 |
Notice of Deposition Duces Tecum of Agency Representative (filed by Respondent via facsimile).
|
Jun. 24, 2004 |
Affidavit of R. Davis Thomas, Jr. (filed via facsimile).
|
Jun. 24, 2004 |
Motion to Allow R. Davis Thomas, Jr. to Appear as Respondent`s Qualified Representative (filed by Respondent via facsimile).
|
Jun. 04, 2004 |
Order Granting Continuance and Re-scheduling Video Teleconference (video hearing set for July 23, 2004; 9:00 a.m.; Fort Lauderdale and Tallahassee, FL).
|
Jun. 02, 2004 |
Motion for Continuance (filed by Petitioner via facsimile).
|
May 28, 2004 |
Respondent`s Notice of Services of Answers to Petitioner`s First Set of Interrogatories (filed via facsimile).
|
May 28, 2004 |
Response to Request for Production of Documents (filed by Respondent via facsimile).
|
May 28, 2004 |
Response to Petitioner`s First Request for Admissions (filed via facsimile).
|
May 13, 2004 |
Order of Pre-hearing Instructions.
|
May 13, 2004 |
Notice of Hearing (hearing set for June 18, 2004; 9:00 a.m.; Fort Lauderdale, FL).
|
May 12, 2004 |
Response to Order (filed by D. Stinson via facsimile).
|
May 05, 2004 |
Order Requiring Response (no later than May 12, 2004, the parties shall advise in writing of additional suggested dates for scheduling the hearing).
|
Apr. 22, 2004 |
Notice of Service of Petitioner`s First Set of Request for Admissions, Interrogatories, and Request for Production of Documents (filed via facsimile).
|
Apr. 16, 2004 |
Joint Response to Initial Order (filed by Respondent via facsimile).
|
Apr. 09, 2004 |
Initial Order.
|
Apr. 08, 2004 |
Request for Formal Administrative Hearing filed.
|
Apr. 08, 2004 |
Administrative Complaint filed.
|
Apr. 08, 2004 |
Notice (of Agency referral) filed.
|