Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: EMERALD SHORES HEALTH CARE ASSOCIATES, LLC
Judges: DIANE CLEAVINGER
Agency: Agency for Health Care Administration
Locations: Panama City, Florida
Filed: Jun. 19, 2007
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Monday, September 17, 2007.
Latest Update: Dec. 23, 2024
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STATE OF FLORIDA 07 JUN |
AGENCY FOR HEALTH CARE ADMINISTRATION 3 PM it: 31
OV ispae ap
STATE OF FLORIDA, AGENCY FOR Abi pH OF
HEALTH CARE ADMINISTRATION, HEARINGS IVE
Petitioner, AHCA Nos.:
2007000671, 2007000674
v.
EMERALD SHORES HEALTH CARE
ASSOCIATES, LLC,
Respondent.
ADMINISTRATIVE COMPLAINT
CoMES NOW the Agency for Health Care. Administration
(hereinafter “AHCA”), by and through undersigned counsel, and
: files’ this Administrative Complaint against EMERALD SHORES
_ HEALTH CARE ASSOCIATES, LLC, (hereinafter “Respondent”), and
alleges:
NATURE OF THE ACTION
1. This is an action to impose upon Respondent, pursuant
to Sections 400.23 (7) and 400.23(8), Florida Statutes (2005) '
and Rule S9A-4.107(5), Florida Administrative Code, an
administrative fine in the amount of $4,000.00. The imposition
of this fine is based on an uncorrected Class III deficiency.
AHCA also intends to impose a conditional rating effective
November 19, 2006 through November 30, 2006, pursuant to section
400.23(7), Florida Statutes (2005).
JURISDICTION AND VENUE
2. This court has jurisdiction pursuant to: Sections
120.569 and 120.57, Florida Statutes (2005), and Chapter 28-106,
Florida Administrative Code (2005) .
3. Venue lies in Bay County, pursuant to Rule 28-106.207,
Florida Administrative Code (2005).
PARTIES
4. AHCA is the enforcing authority with regard to skilled
nursing facility licensure pursuant to Chapter 400, Part II,
Florida Statutes (2005), and Chapter S9A-4, ” Plorida
Administrative Code (2005).
5. Respondent is a skilled nursing facility located at
626 North Tyndall Parkway, Calloway, FL 32404 having been issued
skilled nursing facility license number 1292096. Respondent. was
at all times material hereto a licensed facility under the
licensing authority of AHCA and was required to comply with all
applicable rules and statutes. , |
CouNT I
RESPONDENT FAILED TO PROMOTE CARE FOR RESIDENTS IN AN
ENVIRONMENT THAT MAINTAINS OR ENHANCES EACH RESIDENT’S DIGNITY
SECTION 400-022 FLORIDA STATUTES (2006)
UNCORRECTED CLASS III VIOLATION
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6. AHCA re-alleges and incorporates paragraphs (1)
through (5) as if fully set forth herein.
7. An annual Survey was conducted on November 19, 2006.
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Deficiencies were identified. The facility is not in compliance
with Section 400-022, Florida Statutes (2006).
On November 19, 2006, based on observation, and —
8.
erview, it was determined the facility failed to promote care
or residents in an environment that maintains or enhances each
ent's dignity by staff pushing resident in the hallway
ithout a foot rest on the wheelchair, therefore, dragging their
feet by not assisting: resident to the bathroom forcing resident
to urinate in her adult depends, and allowing residents to
Pemain in soiled clothing for five (5) of nineteen (19) sampled
residents. (#10,#12,#16,#18,#19). The findings include as
reported by the surveyor:
1. During the lunch time observation on 11/19/06 at approximately 1:00 p.m., a
Certified Nursing Assistant (C.N.A. # 1) was observed assisting residents back to
the unit after lunch was completed. C.N.A. #1 was observed pushing resident #
16's wheelchair down the hallway with her feet dragging the floor. An open area
was observed on resident's 16's right ankle.
An interview was conducted with this C.N.A. on 11/19/06 at approximately 1:03
p.m. The C.N.A. stated resident # 16 received a skin tear from the rod on the
'. wheelchair and did not know if she had any foot rest for the wheel chair.
2. Another C.N.A. (C.N.A. # 2) was observed pushing a wheelchair with resident
# 10 dragging her feet on the floor on 11/19/06 at approximately 1:04 p.m.
An interview was conducted with C.N.A. # 2 on 11/19/06 at approximately 1:04
p.m. C.N.A. stated she did know if resident # 10 had any foot rest.
An interview was conducted with the Unit Manager on 11/19/06 at approximately.
1:10 p.m. The Unit Manager stated C.N.A #1 and C.N.A. # 2 should have place
foot rest on the wheelchair prior to pushing their wheelchairs. The Unit Manager
acknowledged the foot rest were taken off the wheel chair in order for the
residents to self propelled themselves. _
3. Resident # 18 was observed on 11/19/06 at approximately 5:30.p.m..being
pushed into the dining room by C.N.A. #4 with his feet dragging the floor.
Resident # 18's wheelchair was lacking the foot rests. a
4. This surveyor heard someone yelling, "I can't hold it any longer.“Iam going to
pee on myself. I can't hold it. I need some help". This surveyor € resident
# 12's room. Resident # 12 stated, "I just peed on myself. I couldn't hold it any
longer. I peed in my diaper". Resident # 12 stated, "C.N.A. #3 pushed me into
my room and told me she would be back and help me to my bathroom"
This surveyor asked her when did she tell C.N.A. #3 she had to l
resident # 12 stated when she was in the dining room. Resident#-12 stated, "she
pushed me in my room and said she had to help the others to get back to their
rooms and would come back to help me but I couldn't wait any | as
This surveyor asked how many times, this occurred, resident # 12 stated 4 or 5
times a day. Resident # 12 stated, "the reason is because they have to get another
person to help me get on the toilet. What I really hate is to be in the hallway
around other people and I have to pee in my diaper". When asked if this was
embarrassing to her, resident # 12 stated, "yes". . . :
This surveyor asked how long had she been in her room, resident # 12 stated, "5-6
minutes".
This surveyor stood in the haliway for continuous observation to determine the
time C.N.A. # 3 would return to assist resident # 12. At approximately 1:45 p.m.
(33 minutes later) C.N.A. #3 was observed entering into resident # 12's room to
assist her.
An interview was conducted with C.N.A. #3 on 11/19/06 at approximately 1:45
p.m. C.N.A. #3 stated she was going to change resident # 12's wet adult depends
and stated she was assisting other residents from the dining room to their rooms.
‘Review of the current Minimum Data Set dated 10/2/06 revealed a code of "1" for
Cognitive/Decision making, "3/3 for transferring (extensive assistance with 2
persons) and "2" for Bladder meaning occasional incontinence (extensive
assistance with 2 persons).
Resident # 12 has the capability of telling (cognitive 1) the staff when she needs
assistance to go to the toilet but needs the assistance of two people to be placed on
the toilet. Resident # 12 did not receive the assistance to the bathroom and was
forced urinate on herself, causing embarrassment. This surveyor observed
resident # 12 sitting in her urine soaked adult depends for 33 minutes before a
C.N.A. came to assist her to the toilet. .
i)
5. Resident # 19 was observed sitting across from the nurse's station on 11/19/06
at approximately 5:45 p.m. with the Risk Manager adjusting a blanket placed on
her feet. When the Risk Manager walked away from resident # 19, this surveyor
observed a large patch of a brown substance and dried substances of food.
An interview was conducted with the Risk Manager on 11/19/06 at approximately
5:50 p.m. The Risk Manager acknowledged the brown substance and dried food
substance and stated'she had not notice them.
6. Review of the facility's policy, "Dignity" revealed the statement of "6.
Respecting resident's private space and property. 3. Make sure clothing is clean".
This class III deficiency was originally cited on or
about 10/04/06, given a correction date of 11/05/06, and was
‘recitéd on 11/19/06.
10. The above constitutes an uncorrected Class III
violation, as defined in Section 400.022, Florida Statutes
(2005), which carries an assessed fine of not less than
$4000. 00 .
COUNT ITI
BECAUSE ONE UNCORRECTED CLASS IIT DEFICIENCY EXISTED AT THE TIME
OF THE FOLLOW UP SURVEY TO THE ANNUAL RE- -LICENSURE SURVEY,
IMPOSITION OF A CONDITIONAL LICENSE IS WARRANTED
SECTION 400.23(7) (b), FLORIDA STATUTES (2006)
11. The Agency re-alleges and incorporates paragraphs (1)
through (5) and (7) through (9) as if fully set forth herein.
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12. Based upon Respondent’s one uncorrected cited State
Class III deficiency, it was not in substantial compliance at
the time of the revisit survey with criteria established under
Part. II of Florida Statute 400, or with rules adopted by the
Agency, a violation subjecting it to assignment ef conditional
licensure status pursuant to Section 400.23(7) (b);:. Florida
Statutes (2006).
13. Wherefore, the Agency intends to assign a cond tional
licensure status to Respondent with an
t
November 19, 2006 through November 30, 2006.
CLAIM FOR RELIEF
WHEREFORE, Petitioner, State of Florida, Agency for Health
Care Administration, requests the following relief:
1. Make factual and legal findings in favor of the Agency
on Count I.
2. Assess against Respondent an administrative fine of
$4000.00 for the violation cited above.
3. Assess costs related to the investigation and
prosecution of this matter, if applicable.
4. Uphold the imposition of a conditional license from
November 19, 2006 through November 30, 2006; and
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5. Grant such other relief as the 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 (2005). Specific options for _administrative
faction are set out in the attached Election of Rights form. All
equests for hearing shall be made to the Agency for Health Care
Administration and delivered to the Agency Clerk, Agency for
“Health Care Administration, 2727 Mahan Drive, MS #3,
Tallahassee, Florida 32308. If you want to hire an attorney,
“you have the right to be represented by an attorney in this
matter. |
RESPONDENT IS FURTHER NOTIFIED THAT FAILURE TO RECEIVE OR
“REQUEST A HEARING WITHIN TWENTY - ONE (21) DAYS OF RECEIPT OF THIS
COMPLAINT, PURSUANT TO THE ATTACHED ELECTION OF RIGHTS, WILL
RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND
THE ENTRY OF A FINAL ORDER BY THE AGENCY.
.“Moore, Esquire
Florida Bar # 0768715
Agency for Health Care
Administration
2727 Mahan Drive, MS #3
Tallahassee, Florida 32308
(850) 922-5873
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Copies furnished to:
Barbara Alford
Field office Manager
Agency for Health Care Administration
(Interoffice Mail)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the
foregoing has been furnished by U.S. Certified Mail, Return
‘Receipt. Requested, to: Owner, 10210 Highland Manor Drive, Suite
250," Tampa, FL 33610 (Receipt # 7004 1160 0003 3739 7876) and to
Administrator Raymond Charpentier, 1304 Woodcrest Avenue, Safety
; 4
Harbor, FL 34695(Receipt # 7004 1160 0003 3739 7869) on this 24
‘day of i 2007.
a,
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Moore, Esquire
Docket for Case No: 07-002742
Issue Date |
Proceedings |
Sep. 17, 2007 |
Order Closing File. CASE CLOSED.
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Sep. 07, 2007 |
Joint Motion to Remand Case to the Agency for Health Care Administrative filed.
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Jul. 18, 2007 |
Order of Pre-hearing Instructions.
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Jul. 18, 2007 |
Notice of Hearing (hearing set for September 13, 2007; 10:00 a.m., Central Time; Panama City, FL).
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Jun. 20, 2007 |
Initial Order.
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Jun. 19, 2007 |
Standard License filed.
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Jun. 19, 2007 |
Conditional License filed.
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Jun. 19, 2007 |
Administrative Complaint filed.
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Jun. 19, 2007 |
Request for Formal Administrative Hearing filed.
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Jun. 19, 2007 |
Notice (of Agency referral) filed.
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