Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: KENDALL HEALTH CARE PROPERTIES III, D/B/A THE PALACE AT KENDALL NURSING AND REHABILITATION CENTER
Judges: ERROL H. POWELL
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Mar. 31, 2006
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Monday, February 12, 2007.
Latest Update: Dec. 23, 2024
FILED
_ ANCA
STATE OF FLORIDA AGENCY CLER Kee »
DIVISION OF ADMINISTRATIVE HEARINGS) yiq ny, jy bbe [> fh
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Petitioner,
vs CASE NO. 06-1136MPI
CI NO. 05-3004-000
KENDALL HEALTHCARE PROPERTIES III,
d/b/a THE PALACE AT KENDALL NURSING
AND REHABILITATION CENTER,
RENDITION NO.: AHCA-€"'1-C453 -S-MDO
Respondent.
FINAL ORDER
THE PARTIES resolved all disputed issues and executed
a “Stipulation and Agreement,” which is incorporated by
reference. The parties are directed to comply with the
terms of the “Stipulation and Agreement.” Based on the
foregoing, this proceeding is CLOSED.
DONE and ORDERED on this the ‘, day of
Vprede , 2007, in Tallahassee,
Leon County, Florida.
* Ge Cc. Le Teer Secretary
Agency for Health Care Administration
CASE NO. 06-1136MPI
C.I. NO. 05-3004-000
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:
Peter A. Lewis, Esquire
Goldsmith, Grout, and Lewis, P.A.
307 West Park Avenue, Suite 200
Tallahassee, Florida 32308
Debora Fridie, Esquire
Attorney for Agency
Agency for Health Care
Administration
2727 Mahan Drive
Fort Knox Building 3, Mail Stop 3
Tallahassee, Florida 32308
The Honorable Errol H. Powell
Administrative Law Judge
Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
Medicaid Program Integrity, MS #6
CASE NO. 06-1136MPI
C.I. NO. 05-3004-000
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the
foregoing Final Order has been furnished to the above named
addressees by U.S. Mail on this the De iay of
JP fare hk , 2007.
Agency Clerk
State of Florida
Agency for Health Care
Administration
2727 Mahan Drive,
Building #3, Mail Stop 3
Tallahassee, Florida 32308-5403
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
AGENCY FOR HEALTH
CARE ADMINISTRATION,
Petitioner, Case No. 06-1136MPI
vs.
KENDALL HEALTHCARE PROPERTIES III,
d/b/a THE PALACE AT KENDALL NURSING
AND REHABILITATION CENTER,
Respondent.
STIPULATION AND AGREEMENT
The Petitioner, STATE OF FLORIDA, AGENCY FOR HEALTH CARE
ADMINISTRATION (a/k/a “AHCA” or “the Agency”), and the
Respondent, KENDALL HEALTHCARE PROPERTIES III, d/b/a THE PALACE
AT KENDALL NURSING AND REHABILITATION CENTER, (a/k/a “PROVIDER”
or “KENDALL”), by and through the undersigned, hereby stipulate
and agree as follows:
1. The two parties enter into this agreement for the
purpose of memorializing the resolution to this matter.
2. PROVIDER is a Medicaid provider in the State of
Florida, operating under provider number 020332700.
3. In its Final Agency Audit Report, C.1I. No. 05-3004~-000
(the "Audit Letter"), AHCA notified PROVIDER that review of
Medicaid claims performed by Medicaid Program Integrity (MPI)
indicated that, in its opinion, some claims in whole or in part
Page 1 of 9
Case No: 06-1136MPI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
were not covered by Medicaid. The Agency sought repayment of an
overpayment amount of the amount of $47,517.29.
In response, PROVIDER petitioned for a formal
administrative hearing with the Division of Administrative
Hearings, Case No. 06-1136MPI. After the provider requested a
formal hearing, AHCA reviewed additional information that was
previously unavailable to them. Based upon that review, AHCA
adjusted the overpayment amount to $28,624.46. PROVIDER has
agreed to pay the adjusted overpayment amount of $28,624.46 plus
some of AHCA’s investigative costs in the amount of $3,375.54,
for a total repayment amount of $32,000.00.
4. In order to resolve this matter without further
administrative proceedings, PROVIDER and AHCA expressly agree as
follows:
(a) AHCA will accept the payment set forth herein as
settlement of the overpayment issues arising from
the MPI review cited in paragraph 3 above.
(ob) Within thirty (30) days of issuance of the Final
Order, PROVIDER agrees to make a single payment to
AHCA of Thirty-Two Thousand and no/100 Dollars
($32,000.00). Of this amount, $28,624.46 is to
reimburse the Medicaid Program for the overpayment
amount due, and $3,375.54 is to reimburse AHCA in
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Case No: 06-1136MPI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
(c)
(e)
part for investigative costs. AHCA retains the
right to perform a 6-month follow-up review.
PROVIDER is responsible for ensuring timely delivery
of the payment. Failure to timely make the payment
will render the balance due and payable immediately,
with interest, and interest will continue to accrue
until the entire balance is paid.
PROVIDER and AHCA agree that full payment as set
forth above will resolve and settle this case
completely and release all parties from ail
liabilities arising from the findings in the audit
referenced as C.I. 05-3004-000.
PROVIDER agrees that it will not rebill the Medicaid
Program in any manner for claims that were not
covered by Medicaid, which are the subject of the
audit in this case.
PROVIDER agrees to fully cooperate with any follow
up reviews conducted by the Agency.
Payment shall be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
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Case No: 06-1136MPI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
And payment shall clearly indicate that it is per a stipulation
and agreement and shall reference the C.I. Number and the
Provider Number.
6. 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.
7. AHCA reserves the right to enforce this Stipulation
and Agreement under the laws of the State of Florida, the Rules
of the Medicaid Program, and all other applicable rules and
regulations.
8. Except as specifically set forth in paragraphs 3 and
4(b) above with regard to AHCA’s investigative costs, the
parties agree to bear their own attorney’s fees and other costs,
if any.
9. The signatories to this Agreement, acting ina
representative capacity, represent that they are duly authorized
to enter into this Agreement on behalf of the respective
parties. Furthermore, PROVIDER agrees that its signature alone
binds PROVIDER to make the payment as set forth in this
agreement. PROVIDER shall furnish the actual signed Stipulation
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Case No: 06-1136MPTI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
and Agreement to AHCA; however a facsimile copy shall be
sufficient to enable AHCA to cancel a hearing scheduled in this
case.
10. 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.
11. 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.
12. 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 understandings,
information and contentions as to facts and law, so that no
misunderstanding or misinformation shall be a ground for
rescission hereof. This Stipulation and Agreement does not
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Case No: 06-1136MPI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
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 resolved because the
parties have agreed to the terms contained within this
agreement.
13. PROVIDER expressly waives in this matter its right to
any hearing pursuant to §§120.569 or 120.57, Florida Statutes,
the making of findings of fact and conclusions of law by the
Agency, and all further and other proceedings to which it may be
entitled by law or rules of the Agency regarding this proceeding
and any and all issues raised herein. PROVIDER further agrees
that the Agency should issue a Final Order which is consistent
with the terms of this stipulation and agreement and which
adopts this agreement and closes this matter.
14. Provider does hereby discharge the State of Florida,
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, C.I. No. 05-3004-000, and AHCA’s actions
herein, including, but not limited to, any claims that were or
may be asserted in any federal or state court or administrative
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Case No: 06-1136MPI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
forum, including any claims arising out of this agreement, by or
on behalf of Provider.
15. This Stipulation and Agreement is and shall be deemed
jointly drafted and written by all parties to it and shall not
be construed or interpreted against the party originating or
preparing it.
16. To the extent that any provision of this Stipulation
and Agreement is prohibited by law, for any reason, such
provision shall be effective to the extent not so prohibited,
and such prohibition shall not affect any other provision of
this Stipulation and Agreement.
17. This Stipulation and Agreement shall inure to the
benefit of and be binding on each party’s successors, assigns,
heirs, administrators, representatives and trustees.
18. All times stated herein are of the essence in this
Stipulation and Agreement.
19. This Stipulation and Agreement shall be in full force
and effect upon execution by the respective parties in
counterpart.
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Case No: 06-1136MPI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
RESPONDENT
THE PALACE AT KENDALL NURSING
AND REHABILITATION CENTER
Oscar Koiz , Fo
(Printed name and title)
Date: >[>/07 , 2007
GOLDSMITH, GROUT AND LEWIS
CO ,
BY: fo
MZ
PETER A. LEWIS, ESQUIRE
Attorney for Respondent Kendall
Date: -A7-OF7 , 2007
Page 8 of 9
Case No: 06-1136MPI
C.I. No. 05-3004-000
AHCA v. Kendall Health Care Properties III
Stipulation and Agreement
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
BY:
LI KEEN
Inspector General
Date: Es , 2007
General Counsel
Date: Wace Ki , 2007
x x
© ape
DEBORA E. FRIDIE
Assistant General Counsel
Date: Febcvary QQ , 2007
Page 9 of 9
Docket for Case No: 06-001136MPI
Issue Date |
Proceedings |
Mar. 26, 2007 |
Final Order filed.
|
Feb. 12, 2007 |
Order Closing File. CASE CLOSED.
|
Feb. 12, 2007 |
Notice of Stipulation in Principle and Joint Motion to Close File filed.
|
Jan. 30, 2007 |
Agency`s Amended Witness List filed.
|
Jan. 09, 2007 |
Order Granting Official Recognition.
|
Nov. 17, 2006 |
Agency`s Motion for Official Recognition filed.
|
Nov. 17, 2006 |
Order of Pre-hearing Instructions.
|
Nov. 17, 2006 |
Notice of Hearing (hearing set for February 15, 2007; 9:00 a.m.; Tallahassee, FL).
|
Nov. 13, 2006 |
Joint Status Report and Notice of Availability for Rescheduled Hearing filed.
|
Nov. 02, 2006 |
Order Granting Continuance (parties to advise status by November 13, 2006).
|
Nov. 01, 2006 |
Motion for Continuance filed.
|
Oct. 30, 2006 |
Agency`s Witness List filed.
|
Oct. 25, 2006 |
Response to Agency`s First Request for Admissions filed.
|
Sep. 25, 2006 |
Agency`s First Request for Admissions filed.
|
Sep. 12, 2006 |
Order Granting Continuance and Re-scheduling Hearing (hearing set for November 14, 2006; 9:00 a.m.; Tallahassee, FL).
|
Sep. 11, 2006 |
Agency`s Motion for Continuance Unopposed by the Respondent filed.
|
Jul. 07, 2006 |
Order of Pre-hearing Instructions.
|
Jul. 07, 2006 |
Notice of Hearing (hearing set for September 26, 2006; 9:00 a.m.; Tallahassee, FL).
|
Jun. 29, 2006 |
Joint Status Report filed.
|
Jun. 21, 2006 |
Order Granting Continuance (parties to advise status by July 5, 2006).
|
Jun. 21, 2006 |
Petitioner`s Notice of Production from Non-party filed.
|
Jun. 20, 2006 |
Motion for Continuance filed.
|
Jun. 20, 2006 |
Order Restricting Use and Disclosure of Information Concerning Medicaid Program Beneficiaries.
|
Jun. 09, 2006 |
Respondent`s Motion to Restrict Use and Disclosure of Information Concerning Medicaid Program Beneficiaries filed.
|
May 25, 2006 |
Agency`s Notice of Cancellation of Deposition Duces Tecum filed.
|
Apr. 14, 2006 |
Order of Pre-hearing Instructions.
|
Apr. 14, 2006 |
Notice of Hearing (hearing set for July 12, 2006; 9:00 a.m.; Tallahassee, FL).
|
Apr. 13, 2006 |
Joint Response to Order Requiring Response, Including Request for Hearing to be Set More than 90 Days from Date of Assignment of Judge Pursuant to s.409.913(31), FLA. STAT. filed.
|
Apr. 10, 2006 |
Order Requiring Response (response regarding mutually agreeable dates for the hearing due April 20, 2006).
|
Apr. 10, 2006 |
Agency`s Notice of Deposition Duces Tecum filed.
|
Apr. 10, 2006 |
Agency`s Notice of Filing Agency`s Notice of Deposition Duces Tecum filed.
|
Apr. 07, 2006 |
Joint Response to Order Granting Motion to Reopen File filed.
|
Mar. 31, 2006 |
Order Granting Motion to Reopen File.
|
Mar. 29, 2006 |
Agency`s Motion to Reopen Proceeding (formerly DOAH Case No. 05-2879MPI) filed.
|
Aug. 11, 2005 |
Final Agency Audit Report filed.
|
Aug. 11, 2005 |
Petition for Formal Administrative Hearing filed.
|
Aug. 11, 2005 |
Order of Dismissal without Prejudice Pursuant to Sections 120.54 and 120.569, Florida Statutes and Rules 28-106.111 and 28-106.201, Florida Administrative Code to Allow for Amendment and Resubmission of Petition filed.
|
Aug. 11, 2005 |
Amended Petition for Formal Administrative Hearing filed.
|
Aug. 11, 2005 |
Notice (of Agency referral) filed.
|