STATE OF FLORIDA Lay < é AGENCY FOR HEALTH CARE ADMINISTRATION © 4°" 4. 2089" F 4) 29 | STATE OF FLORIDA, AGENCY ns joy FOR HEALTH CARE ADMINISTRATION, 4s Vip" Oo hy ua: BOS Petitioner, AHCA No: 2006010350 Vv. CASE No: 06-397PH © ACRS, INC. d/b/a ACTIVE DAY OF HOLLYWOOD, Respondent. EY ACRS, INC. d/b/a ACTIVE DAY OF HOLLYWOOD, Petitioner, AHCA No: 2006010172 v. DOAH No: 06-4928 STATE OF FLORIDA, AGENCY FOR HEALTH ADMINISTRATION, Respondent / FINAL ORDER Having reviewed the administrative complaint 2006010350 dated December i1, 2006, and a Notice of Intent to Deny on case 2006010172 dated November 16, 2006, attached hereto and incorporated herein (Exs. 1 and ia.), and all other matters of record, the Agency for Health Care Administration (“Agency”) has entered into a Settlement Agreement (Ex. 2) with the other party to these proceedings, and being otherwise well-advised in the premises, finds and concludes as follows: ORDERED: 1. The attached Settlement Agreement is approved and adopted as part of this Final Order, and the parties are directed to comply with the terms of the Settlement Agreement. 2. Active Day of Hony./70d shall nay >> - J vinistrative fine in the amount of $5,000.00. The administrative fine 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: Agency for Health Care Administration Office of Finance and Accounting Revenue Management Unit 2727 Mahan Drive, MS# 14 Tallahassee, Florida 32308 4. Unpaid fines pursuant to this Order will be subject to statutory interest and may be collected by all methods legally available. 5. Active Day of Hollywood's application for initial licensure on case #2006010172 is deemed withdrawn. 6. Active Day of Hollywood agrees that it will not operate a facility in Broward County for five years following the entry of this Final Order. 7. Active Day of Hollywood's petitions for formal and/or informal administrative proceedings on Case #2006010172 and Case #2006010350 are hereby dismissed. 8. Each party shall bear its own costs and attorney’s fees. 9. The above-styled cases are hereby closed. 204, DONE and ORDERED this 027 Gay of in Tallahassee, Leon County, Florida. A Benson, Kaw 2 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 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: Jay Adams, Esquire Attorney for Active Day of Hollywood Broad and Cassel 215 S. Monroe Street, Suite 400 Tallahassee, Florida 32302 (U. S. Certified Mail) Finance & Accounting Revenue Management Unit Agency for Health Care Administration 2727 Mahan Drive, MS #14 Tallahassee, Florida 32308 (Interoffice Mail) Jan Mills Agency for Health Care Administration 2727 Mahan Drive, Bldg #3, MS #3 Tallahassee, Florida 32308 (Interoffice Mail) Tria Lawton Russell Assistant General Counsel Agency for Health Care Administration 8350 NW 52" Terrace, Suite 103 Miami, Florida 33166 (Interoffice Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive, Bldg #1, MS #9 Tallahassee, Florida 32308 (Interoffice Mail) Hon. Stuart M. Lerner Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) William H. Roberts, Esq. Informal Hearing Officer Agency for Health Care Administration 2727 Mahan drive, Mail stop #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 20" Gay of Fe&e , 20277 Y Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA py “ Lops AGENCY FOR HEALTH CARE ADMINISTRATION Mp hah : an STATE OF FLORIDA, 4s, Vy, AGENCY FOR HEALTH KEEST Son 9% CARE ADMINISTRATION, WMigiy, fe Petitioner, , AHCA No: 2006010350 Case No: 06- 397PH VS. ACRS, INC. d/b/a ACTIVE DAY OF HOLLYWOOD, Respondent. ACRS, INC. d/b/a ACTIVE DAY OF HOLLYWOOD, Petitioner, VS. AHCA No: 2006010172 DOAH No: 06- 4928 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT State of Florida, Agency for Health Care Administration (hereinafter the "Agency"), through its undersigned representatives, and ACRS, Inc. d/b/a Active Day of Hollywood (hereinafter "Active Day of Hollywood"), pursuant to Section 120.57(4), Florida Statutes, each individually, a "party," collectively as "parties," hereby enter into this Settlement Agreement ("Agreement") and agree as follows: EXHIBIT _ A WHEREAS, Active Day of Hollywood was an adult day care center licensed pursuant to Chapter 429, Part III, Florida Statutes, Section 20.42, Florida Statutes, and Chapter 58A-6, Florida Administrative Code; and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over Active Day of Hollywood, pursuant to Chapter 429, Part III Florida Statutes; and WHEREAS, the Agency servéd Active Day of Hollywood with an administrative complaint (2006010350) on or about December 12, 2006, notifying Active Day of Hollywood of its intent to impose administrative fines in the amount of $28,000.00, and a Notice of Intent to Deny Active Day of Hollywood's initial licensure application (2006010172) on or about November 16, 2006, and WHEREAS, Active Day of Hollywood was granted an informal administrative proceeding regarding the administrative complaint on case #200601035 and a formal administrative proceeding on the denial action (#2006010172); 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 herein are true and correct and are expressly incorporated herein. 2. Both parties agree that the "whereas" clauses incorporated herein are binding findings of the parties. 3. Upon full execution of this Agreement, Active Day of Hollywood agrees to a withdrawal of its Petition for formal and/or informal administrative proceedings (2006010172 and 2006010350); agrees to waive any and all appeals and proceedings to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), Florida Statutes, a formal proceeding under Subsection 120.57(1), Florida Statutes, appeals under Section 120.68, Florida Statutes; and 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 settlement agreement. 4. Upon full execution of this Agreement, Active Day of Hollywood agrees to the following terms: a. Active Day of Hollywood shall pay $5,000.00 in administrative fines to the Agency within thirty (30) days of the entry of the Final Order on case #2006010350. b. Active Day of Hollywood's application for initial licensure on case #2006010172 is deemed withdrawn. c. Active Day of Hollywood agrees that it will not operate a facility in Broward County for five years following the entry of the Final Order on case #2006010350. 5. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in Circuit Court in Leon County, Florida. 6. By executing this Agreement, Active Day of Hollywood does not admit or deny, and the Agency asserts the validity of the allegations raised in the administrative complaint and the Notice of Intent to Deny referenced herein. The Agency agrees that it will not impose any further penalty against Active Day of Hollywood as a result of the surveys identified in the administrative complaint and the Agency's Notice of Intent to Deny. Furthermore, no agreement made herein shall preclude the Agency from using the deficiencies from the surveys identified in these administrative complaints in any decision regarding licensure of Active Day of Hollywood, including, but not limited to, licensure for limited mental health, limited nursing services, or extended congregate care. 7. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and closing the above- styled cases. 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. Active Day of Hollywood for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, 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 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 Active Day of Hollywood or related facilities. 11. This Agreement is binding upon all parties herein and those identified in paragraph 10 of this Agreement. 12. In the event ‘that Active Day of Hollywood was a Medicaid provider at the subject time of the occurrences alleged in the complaint herein, this settlement does not prevent the Agency from seeking Medicaid overpayments related to the subject issues. 13. Active Day of Hollywood agrees that if any funds to be paid under this agreement to the Agency are not paid within thirty-one (31) days of entry of the Final Order in this matter, the Agency may deduct the amounts assessed against Active Day of Hollywood in the Final Order, or any portion thereof, owed by Active Day of Hollywood to the Agency from any present or future funds owed to Active Day of Hollywood by the Agency, and that the Agency shall hold a lien against present and future funds owed to Active Day of Hollywood by the Agency for said amounts until paid. Furthermore, failure to pay the amounts assessed against Active Day of Hollywood in the Final Order will be considered in any future licensure applications by ACRS, Inc. and/or any of its controlling interests. 14. The undersigned have read and understand this Agreement and have the authority to bind their respective principals to it. 15. This Agreement contains understandings and agreements of the parties. and incorporates the entire 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 a facsimile signature suffices for an original signature. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. Elizabeth Dudek Deputy Secretary Division of Health Quality Assurance Agency for Health Care Administration 2727 Mahan Drive, Bldg. #1 Tallahassee, Florida 32308 Dated: Craig Smith General Counsel Agency for Health Care Administration 2727 Mahan Drive, Bldg. 3 Tallahassee, Florida 32308 Dated: Jay Adams . Attorney for Active Day of Hollywood Broad and Cassel 215 S. Monroe Street Suite 400 fA ff CAME | ‘Fria Lawton-Russell Assistant General Counsel Agency for Health Care Administration 8350 NW 52™ Terrace, Suite 103 Miami, Fl 33166 Dated: a le / O&

Docket for Case No: 06-004928