STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION. STATE OF FLORIDA, 10 J 3 aff 1 33 AGENCY FOR HEALTH CARE Case Nos. 05-36a4i' 8 341), 53 ADMINISTRATION, 05-2644 yi5)1) op : 05-2878 NISTRATIVE Petitioner, 2005004465; nog 0” 2005004966 _ vs. ' 2005005411" * MAPLEWAY COMMUNITY, INC., Respondent. / FINAL ORDER Having reviewed the administrative complaints dated July 8, 2005 (Ex. 1), June 28, 2005 (Ex. 2)!, and a Notice of Intent to Deny dated June 29, 2005 (Ex. 3), attached hereto and incorporated herein, and all other matters of record, the Agency for Health Care Administration (“Agency”) has entered . into a Stipulation and Settlement Agreement (Ex. 4) with the parties to these proceedings, and being otherwise well advised in the premises, finds and concludes as follows: ORDERED: 1. The attached Stipulation and Settlement Agreement is approved and adopted as part of this Final Order and the parties are directed to comply with the terms of the Stipulation and Settlement Agreement. ? Counts I, II, and III of the Administrative Complaint dated June 28, 2005 (AHCA Case No. 2005004466), also served as the basis for an Emergency Order of Immediate Moratorium on Admissions (AHCA No. 2005001261) that the Agency imposed upon the Respondent on May 18, 2005. In light of the expiration of the Respondent's assisted living facility license, a 2. Administrative fines and fees totaling $2,161.50 are hereby imposed upon the Respondent. This amount is due and payable within thirty (30) days of the date of rendition of this Order. 3. Checks should be made payable to the “Agency for Health Care Administration.” The check, along with a reference to these case numbers, should be sent directly to: Jean Lombardi Agency for Health Care Administration Office of Finance and Accounting 2727 Mahan Drive, MS# 14 ' Tallahassee, Florida 32308. 4, The Respondent’s petitions for formal administrative proceedings are hereby dismissed. 5. Unpaid fines will be subject to statutory interest and may be » collected by all methods legally available. 6. Each party shall bear its own costs and attorney's fees. 7. The above-styled case is hereby dismissed. DONE and ORDERED this fay of Weaker! 200.5, in Tallahassee, Leon County, Florida. Alan'Levine, me if . Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A moratorium is no longer in force at the Respondent facility and AHCA No. 2005001261 is hereby closed. ‘3 ws 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 OF 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: Christina C. Mesa, Esq. . : Brian T. Mulligan, Esquire Quintairos, Prieto, et al, P/A. Agency for Health Care Admin: 4905 Laurel Street, Suite 200 525 Mirror Lake Drive N., #330L Tampa, FL 33607 St. Petersburg, Florida 33701 (U.S. Mail) (Interoffice Mail) Jean Lombardi Elizabeth Dudek Finance & Accounting Deputy Secretary Agency for Health Care Admin. Agency for Health Care Admin. 2727 Mahan Drive, MS #14 2727 Mahan Drive, Bldg #1, MS #9 Tallahassee, Florida 32308 Tallahassee, Florida 32308 (Interoffice Mail) (Interoffice Mail) _ Jan Mills ‘ Carolyn S. Holifield, ALJ Agency for Health Care Admin. Div. of Administrative Hearings 2727 Mahan Drive, Bldg #3, MS #3 The DeSoto Bidg. Tallahassee, Florida 32308 1230 Apalachee Parkway _(Interoffice Mail) ‘Tallahassee, FL 32399-9675 (Interoffice Mail) CERTIFICATE OF SERVICE J HEREBY CERTIFY that a true and correct copy of this Final Order was served on the above-named person(s) and entities by U.S. Mail, or the method designated, on this the ss day of __CJewar. , 2086. ae ee Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, DOAH Nos. 05-2624 Petitioner, 05-2644 vs. ' 05-2878 AHCA Nos. 2005004465 2005004466 MAPLEWAY COMMUNITY, INC., 2005005611 Respondent. STIPULATION AND SETTLEMENT AGREEMENT Petitioner, State of Florida, Agency for Health Care Administration (hereinafter “Agency”) by and through its undersigned representatives, and Respondent, Mapleway Community, Inc. (hereinafter “Mapleway”), pursuant to Section 120.57(4), Florida Statutes (2005), each individually, a “party,” collectively as “parties,” hereby enter into this Stipulation and Settlement Agreement (hereinafter “Agreement”) and agree as follows: WHEREAS, Mapleway is an assisted living facility licensed pursuant to Chapter 400 Part II, Florida Statutes (2005), and Rule 58A-5, Florida Administrative Code, (2005); and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over assisted living facilities pursuant to Chapter 400, Part II], Florida Statutes; and WHEREAS, the Agency served Mapleway with Administrative Complaints notifying Mapleway of the Agency’s intent to impose administrative fines and fees totaling of Eleven Thousand Three Hundred Twenty-Three and No/100 Dollars ($11,323.00); and 4 EXHIBIT __ 4 — WHEREAS, the Agency served Mapleway with a Notice of Intent to Deny, dated June 29, 2005, thereby notifying Mapleway of the Agency’s intent to deny Mapleway’s renewal application for a license to operate an assisted living facility in the State of Florida; and ‘WHEREAS, Mapleway requested a formal administrative hearing for the above styled iu ' proceedings; and WHEREAS, the parties have agreed that a fair, efficient, and cost effective resolution of this dispute would avoid the expenditure of substantial sums to litigate the dispute; and WHEREAS, the parties have negotiated and agreed that the best interest of all the parties ' 1! will be served by a settlement of this proceeding; and NOW THEREFORE, in consideration of the mutual promises and recitals herein, the. parties intending to be legally bound, agree as follows: oe 1. en The parties agree that all recitals above are true and correct, expressly incorporated herein, and binding findings of the parties. 2. . Upon full execution of this Agreement, Mapleway agrees to a withdrawal of its Petitions for Formal Administrative Proceedings; agrees to waive any and all appeals and proceedings including, but not limited to, an informal proceeding under Subsection 120.57(2), a formal proceeding under Subsection 120.57(1), appeals under Section 120.68, Florida Statutes, declaratory and all writs of relief in any court or quasi-court (DOAH) of competent jurisdiction, and agrees to waive compliance with the form of the Final Order (findings of fact and ~ conclusions of law) to which it may be entitled. Provided, however, that no agreement herein, shall be deemed a waiver by either party of its right to judicial enforcement of this stipulation. 3. Upon full execution of this Agreement, Mapleway agrees to pay Two Thousand One Hundred Sixty-One and 50/ 100 Dollars ($2,161.50) in administrative fines and fees to the Agency within 30 days of the e entry of the Final Order. 4. Venue for any action brought to enforce the terms of this Agreement, or the Final Order entered pursuant hereto,. shall lie in the Circuit Court in Leon County, Florida. . 5. Mapleway neither admits nor denies the allegations raised in the administrative complaints referenced herein. The Agency agrees that it,will not impose any further penalty against Mapleway as a result of the May 5, 2005; and May 12, 2005 surveys. However, no agreement made herein shall preclude the Agency from imposing a penalty against Mapleway for any deficiency or violation of statute or rule identified in a future survey of Mapleway, which would result in a cumulative or enhanced fine, or an uncorrected or repeat deficiency based upon the surveys of May 5, 2005, and May 12, 2005. Furthermore, no agreement made herein shall preclude the Agency from using the deficiencies from the stirveys completed on May 5, 2005, and May 12, 2005 in any decision regarding licensure except to the extent that the Agency had determined from the investigation preceding this Agreement that certain of such deficiencies would not be pursued by the Agency. 6. The parties agree that the license to operate an assisted living facility previously issued to Mapleway (License #8504) expired on July 31, 2005. The parties further agree that a conditional license, which the Agency is authorized to issue pursuant to Section 400.417(5), Florida Statutes (2005), was never issued to Mapleway during the time Mapleway’s renewal application was pending or during the time an administrative proceeding was pending. Mapleway hereby agrees to voluntarily dismiss its petition to challenge Agency’s Notice of Intent to Deny dated June 29, 2005. The parties agree that, following the execution of this Agreement, Mapleway shall submit an initial application and that the Agency shall review such application in accordance with Part I, Chapter 400, Florida Statutes (2005). 7. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and dismissing the above-styled case. a ' 8. Each party shall bear its own costs and attorney’s fees. 9. This Agreement shall become effective on the date upon which it is fully executed by all the parties. 10. Mapleway, for itself and for its related or resulting organizations, its successors or ¢ a transferees, attorneys, heirs, and executors or administrators, does hereby discharge the Agency for Health Care Administration, and its agents, representatives, and attorneys of and from all claims, demands, actions, causes of action, suits, damages, losses, and expenses, of any and every nature, whatsoever, arising out of or in any way related to this matter and the Agency's actions, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative forum, including any claims arising out of this Agreement, by or on behalf of Mapleway or related facilities. 11. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 12. This agreement is intended solely to resolve this litigation between the Agency and Mapleway as the same relates to the Agency’s regulatory responsibilities over Mapleway as pleaded in the Administrative Complaint. | 13. This Agreement is binding upon all parties herein and those identified in the Paragraph Ten (10) of this Agreement. 14. This Agreement contains the entire understandings and agreements of the parties. 15. This Agreement supersedes any prior oral or written agreements between the parties. - 16. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement by Mapleway or related facilities, its successor or any resulting organization, shall'be void. 17. All parties agree that a facsimile signature contained herein shall be as valid and binding as an original signature. 18. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. sa, Esq. Elizabeth Dudek } os, Prieto, et al, P.A. Deputy Secretary. . Qui Managed Care and Health Quality Assurance ‘4905 Laurel Street, Suite 100 Agency for Health Care Administration Tampa, FL. 33607 2727 Mahan Drive Counsel for Mapleway Community, Inc. Tallahassee, Florida 32308 lal 4 10S DATED: l2feog 7 DATED: a Owkay PP). Bas d. a Christa Calamas, General Cotinsel Florida Bar No. 0142123 Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 DATED: [2-27-05

Docket for Case No: 05-002624