, STATE OF FLORIDA een AGENCY FOR HEALTH CARE ADMINISTRATION ©! 15 PE 23 PI EASY LIVING, INC., A a Petitioner, DOAH NO. 05-3104, ; AHCA NO. 2005005; vs. As , , ; toe : STATE OF FLORIDA, AGENCY FOR Ge < HEALTH CARE ADMINISTRATION, Respondent. ef FINAL ORDER Having reviewed the Notice of Intent to Deny dated July 7, 2005, attached hereto and incorporated herein (Ex. 1), and all other matters of record, the“Agency for Health Care Administration (“Agency”) has entered into a‘Stipulation and Settlement Agreement (Ex. 2) 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. 2. The Petitioner’s petition for formal hearing is hereby dismissed. 3. Each party shall bear its own costs and attorney's fees. 4, The above-styled case is hereby dismissed. a Wy DONE and ORDERED this _/% day of kesernbew., 2005, in Tallahassee, Leon County, Florida. Alan Levmwe, Secretary Agency fok 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 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: Linda R. Chamberlain, Esq. Brian T. Mulligan Attorney for Easy Living, Inc. ‘Senior Attorney 901 Chestnut Street, #B: Agency for Health Care Admin. Clearwater, Florida 33756 525 Mirror Lake Drive N., #330L (U. S. Mail) St. Petersburg, Florida 33701 (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 Agency for Health Care Admin. 2727 Mahan Drive, Bldg #3, MS #3 Tallahassee, Florida 32308 (Interoffice Mail) ' CERTIFICATE OF SERVICE I 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 ZP“Gay Of «fate Se, 2005. fi Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 , JEB BUSH, GOVERNOR . Administrator Clearwater, FL 33757 \ FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION ALAN LEVINE, SECRETARY . July 7, 2005 ‘ CERTIFIED MAIL Easy Living Inc. =, SENDERS RECORD... P.O Box 432 btn RE: Initia] application for license Complaint # 2005005713 NOTICE OF INTENT TO DENY. The application for licensure of the above named company as a home health agency is being denied for failure to provide proof of financial ability to operate. A letter with items that were omitted from your application was sent May 12,, 2005. Responses to the omission letter were. received June 10, 2005. The response did not meet the requirements in state law and rules and your agency failed to demonstrate financial ability to operate. The specific requirements that were not met are: : 1. The applicant did not demonstrate financial ability to operate. The following item from the response to the first omission letter was the basis for the decision: Applicants own estimation of start-up costs and working capital need on schedule 1 was $103,335. Although the applicant claimed to have sufficient assets, the only evidence presented that these assets actually existed was a series of cancelled checks totaling to $1,123.85 representing previous expenditures, and a line of credit agreement from a bank showing a - balance of $8,462.03. The pertinent statutes and rules that apply include: Section 400.47 1 (2) (c), F.S., “The applicant must file with the application satisfactory proof that the home health agency is in compliance with this part and applicable rules, including: (c) Proof of financial ability to operate.” Section 400.47 1 (3), F.S., “An applicant for initial licensure must demonstrate financial ability to operate by submnitting a balance sheet and income and expense statement for the first 2 years of operation which provide evidence of having sufficient assets, credit, and projected revenues to cover liabilities and expenses. The applicant shall have demonstrated financial EXEQBIT tabbles’ Visit A ww. fq 2727 Mahan Drive * Mail Stop #1 Tallahassee, FL. 32308 , : » Easy Living, Inc. @ @ tos ability to operate if the applicant’s assets, credit, and projected revenues mect or exceed projected liabilities and expenses. All documents required under this subsection must be Section 400.474 (2) (a), F.S., “Any of the following actions by a home health agency o: employee is grounds for disciplinary action by the agency: (4) Violation of this part or applicable rules.” - ‘ Section 59A-8.004 (5) Florida Administrative Code (FAC), “For initial applications, including changes of ownership, the applicant must submit proof of financial ability to operate, pursuant to 5.400.471 (3), F-S., The compliance is demonstrated by completion of schedules 1 through 7 of the home health agency application, as referenced in subsection (1) above.” EXPLANATION OF RIGHTS Pursuant to Section 120.569, Florida Statutes, (F.S.) you have the right torequest an. administrative hearing. In order to obtain a formal proceeding before the Division of Administrative Hearings under Section 120.57(1), F.S.,. your request for an administrative hearing miust conform to the requirements in Section 28-106.111 Florida Administrative Code (F.A.C), Section 28-106.201 Florida Administrative Code (F.A.C), and must state the material facts you dispute. In order td ‘preserve the right to a hearing, the Election of Rights form, in this matter, must be received by the Agency for Health Care Administration within twenty-one (21) days from the date the Notice of Intent to Deny is received by licensee. If the election of rights form with the selected option is not received by the Agency for Health Care Administration within twenty-one (21) days from the date of the receipt of Notice of Intent to Deny, a final order will be issued finding the deficiencies and/or violations charged and imposing the penalty sought. Agency for Health Care Administration By Cant a Anne Menard as Unit Manager Home Care Unit Health Facility Regulation Copy: Agency Clerk, MS 3 Wendy Adams, MS 3 Enclosed: Election of Rights Form Explanation of Election of Rights Form STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION EASY LIVING, INC. Petitioner, vs. , AHCA No. 2005005713 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / STIPULATION AND SETTLEMENT AGREEMENT Respondent, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (hereinafter “Agency”), by and through its undersigned representatives, and Petitioner, EASY LIVING, INC. (hereinafter “Petitioner”), by and through it undersigned representative, pursuant to Section 120.57(4), Florida Statutes (2004), each individually a “party,” collectively as “parties,” hereby enter into this Stipulation and Settlement Agreement (“Agreement”) and agree as follows: WHEREAS, the Petitioner is an applicant for home health agency licensure pursuant to Chapter 400, Part IV, Florida Statutes (2004), and Chapter 59A-8, Florida Administrative Code (2004); and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over licensure of home health agencies pursuant to Chapter 400, Part IV, Florida Statutes (2004), and Chapter 59A-8, Florida Administrative Code (2004); and WHEREAS, the Agency served the Petitioner with a Notice of Intent to Deny dated July 7, 2005, notifying the Petitioner of the Agency’s intent to deny Petitioner’s initial application for license to operate a home health agency in the State of Florida; and | WHEREAS, the Petitioner requested a formal administrative hearing by selecting Option Three (3) on the Election of Rights for Notice of Intent form and by submitting an Amendment to Petition to Request Hearing; 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 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: 1, - All recitals above are true and correct, expressly incorporated herein, and binding findings ‘of the parties. 2. Upon full execution of this Agreement, the Petitioner agrees to a withdrawal of its request for a formal administrative proceeding; agrees to waive any and all appeals and proceedings; agrees to waive compliance with the form of the final order (findings of fact and conclusions of law) to which it may be entitled; agrees to waive its right to an informal proceeding under Section 120.57(2), Florida Statutes (2004), a formal proceeding under Section ° 120.57(1), Florida Statutes (2004), appeals under Section 120.68, Florida Statutes (2004); and agrees to waive its right to declaratory relief and all writs of relief in any court or quasi-court (DOAH) of competent jurisdiction. 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, the parties agree that the Notice of Intent ’ to Deny issued by the Agency on or about July 7, 2005, is deemed withdrawn. 4. Upon full execution of this Agreement, the parties agree that the Petitioner’s election for formal administrative proceeding is deemed withdrawn. 5. Upon full execution of this Agreement, the Petitioner agrees to remit to the Agency EIGHT HUNDRED THIRTY AND NO/ 100 DOLLARS ($830.00). Upon the Agency’s receipt of such amount, and in conjunction with the BIGHT HUNDRED THIRTY AND NO/100 DOLLARS ($830.00) previously submitted, the Petitioner’s application for home health agency licensure will be deemed submitted and the 60-day time period in which the Agency must take final action on the Petitioner’s initial licensure application pursuant to Section 400.471(1), Florida Statutes (2004), will commence. If the Agency thereafter approves the Petitioner’s initial licensure application, the Agency shal] issue to the Petitioner a license to operate a home health agency for a period of two (2) years. a , 6. ‘The Petitioner shall submit the additional EIGHT HUNDRED THIRTY AND NO/100 DOLLAR ($830.00) licensing fee to the Agency on or before October 15, 2005. The Petitioner shall send such amount to the Agency, in the care of Janet E. Benesh, at the following address: AHCA HOME CARE UNIT 2727 MAHAN DRIVE - MAIL STOP # 34 TALLAHASSEE, FLORIDA 32308 7. Nothing in this Agreement shall prohibit the Agency from denying Petitioner’s initial licensure application based upon Petitioner’s failure to comply with any statutory or regulatory requirement for licensing or operating a home health agency, or the Petitioner’s failure to a satisfactorily complete a survey pursuant to Rule 59A-8.003, Florida Administrative Code (2004). 8.) 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. 9. 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. 10." Each party shall bear its own costs and attorney’s fees. i. This Agreement shall become effective on the date upon which it is fully executed by all the parties. 12. The Petitioner for itself and for its related or resulting organizations, its successors’or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the Agency, 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 adthiniisirative forum, including any claims arising out of this agreement, by or on behalf of the Petitioner or related facilities. 13. This Agreement is binding upon all parties herein and those identified in Paragraph Twelve (12), above. 14. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 15. This Agreement contains the entire understandings and agreements of the parties. 16. This Agreement supersedes any prior oral or written agreements between the parties. 17. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void. 18. All parties agree that any facsimile signature contained herein shall be as valid and binding as an original signature. 19. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. thon. india R. Chamberlain, Esq. Deputy Spcretary Attorney for Easy Living, Inc. Managed Care and Health Quality Assurance ; 901 Chestnut Street, Suite B Agency for Health Care Administration Clearwater, Florida 33756 2727 Mahan Drive Tallahassee, Florida 32308 DATED: PTIG JOS DATED: _/2/5 / 0.5 Christa Calamas, General Counsel Florida Bar No. 0142123 Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 DATED: \#)it [as~

Docket for Case No: 05-003104