Oo “egy Fey Pf STATE OF FLORIDA "Koy 9 “4 AGENCY FOR HEALTH CARE ADMINISTRATION Dy Py Aoife 8Ip, "Oy STATE OF FLORIDA, AGENCY FOR HEALTH _ st Spt Qe: CARE ADMINISTRATION, OT _ S| § | Vitis , Petitioner, AHCA No.: 2006009991 , Return Receipt Requested: ve - 7002 2410 0001 4232 0152 7002 2410 0001 4232 0169 TROPICAL HAVEN, INC. d/b/a : TROPICAL HAVEN, Respondent. ADMINISTRATIVE COMPLAINT COMES NOW State of " Plorida, Agency for Health Care Administration (“AHCA”), by and through the undersigned counsel, and files this administrative complaint against Tropical Haven, Inc. d/b/a Tropical Haven (hereinafter “Tropical. Haven”), ‘pursuant to Chapter 429, Part I, and Section 120.60, Florida Statutes (2006), and alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine of $23,000.00 pursuant to Sections 429.14 and 429.19, Florida Statutes (2006), for the protection of public health, safety and welfare. JURISDICTION AND VENUE 2. This Court has jurisdiction pursuant to Sections 120.569 and 120.57, Florida Statutes (2006), and Chapter 28-106, Florida Administrative Code (2006). 3. Venue lies in Broward County pursuant to Section 120.57, Florida Statutes (2006), and Rule 28-106.207, Florida Administrative Code (2006). PARTIES 4. AHCA is the regulatory authority responsible for licensure and enforcement of all applicable statutes and rules governing assisted living facilities pursuant to Chapter 429, Part I, Florida Statutes (2006), and Chapter 58A-5 Florida Administrative Code (2006). 5. Tropical Haven operates a 26 bed assisted living facility located at 460 N. w. 4ot Court, Oakland Park, Florida 33309. Tropical Haven is licensed as an assisted living facility under license number 7480. Tropical Haven 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 TROPICAL HAVEN FAILED TO ENSURE THAT THE PHYSICAL PLANT WAS CLEAN AND IN GooD REPAIR AND THAT ALL APPLIANCES WERE IN Goop WORKING ORDER. RULE 58A-5.023(1) (b), FLORIDA ADMINISTRATIVE CODE ‘(PHYSICAL PLANT STANDARDS) REPEAT CLASS ITT VIOLATION 6. AHCA re-alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. Tropical Haven was cited with a Class III deficiency due to complaint investigation surveys that were conducted on June 12, 2006, August 18, 2006, and October 10, 2006. 8. A complaint investigation Survey was conducted ‘on June 12, 2006. Based on observation and interview, it was determined that the facility failed to ensure that the physical plant wag clean and in good. repair and that all appliances were in good working order. The findings include the following. 9, Upon tour of the facility conducted at approximately 10:35 AM, accompanied by Employee plant issues were identified: 10. Apartment #2: a. The entrance door was b. The common area walls c. Bedroom #2: The room coverings for privacy. #1, the following physical dirty. were in need of paint. lacked window blinds and/or d. Bathroom: The bathroom lacked window blinds and/or coverings for privacy. 11. Apartment #3: a. The entrance door was dirty. b. The common area walls were in need of paint and repair. c. The window, of the common area lacked blinds and/or coverings for privacy. d. 1 of the 2 sofas located in the resident common area was torn and dirty. e. Bedroom #1: The room lacked window blinds and/or coverings for privacy. £. Bedroom #2: 1 of 4 of the drawers on a dresser was broken and in need of repair. . g. Bathroom: The shower control handle has broken. 12. Apartment #4: a. The entrance door was dirty and in need of repair. . b. Quik Krete stucco finish coat was observed stored in the common area. c. Bedroom #2: The room lacked window blinds and/or coverings for privacy. The doorknob was missing; therefore, the resident's are unable to lock the door for privacy. d. Bathroom: Approximately 3 tiles over the tub/shower were missing. 13.. Apartment #5: a. The entrance door was dirty and the door frame was in need of repair. b. Bedroom #1: The room lacked window blinds and/or coverings for privacy. c. Bathroom: The tub was very dirty. The shower curtain was covered with mold. 14. Apartment #6: a. The entrance door was dirty. b. Bedroom #2: The wall located next to bed #2 showed signs of decay and mildew. c. The baseboards surrounding the perimeter of the room showed signs of decay from moisture. The room lacked window blinds and/or coveririgs for privacy. d. Bathroom: The toilet seat lid was detached from the toilet and lying on the floor next to the toilet and sink. ea. The light fixture over the sink was missing a light bulb. 15. Apartment #8: a. The entrance door was dirty. b. Bedroom #1: The room lacked window blinds and/or coverings for privacy. The window contained a strip of gray masking tape that covered a large crack in the window. The doorknob was missing enabling the resident of locking the door for privacy. 16. During an interview with Employee #1, it was reported that the bathroom of apartment #8 was inoperable. 17. During a tour of the dining room the surveyor observed a large hole in the wall over the double doors that divide the dining room and apartment #8. 18. During a later tour of the facility accompanied by the Administrator at approximately 11:30 AM, the findings were acknowledged. 19. Upon tour of the facility at approximately 10:35 AM, accompanied by Employee #1, it was noted that the air conditioning units were inoperable in Apartment #'s 3 and 4. 20. Upon observation during a tour of Apartment #6, it was noted the temperature control knob was missing off of the control panel of the air conditioning unit, which obstructs the _ residents' ability to adjust the air conditioning temperature to meet their own comfort level. 21. During an interview with the Administrator at approximately 1:00 PM, the findings were acknowledged. 22. The mandated date of correction was designated as July 12, 2006. 23. A complaint investigation survey was conducted on August 18, 2006. Based on observation and interview, it was determined that the facility failed to ensure that the physical plant was clean and in good repair and that all appliances were in good working order. The findings include the following. 24. Upon tour of the facility conducted at approximately 12:00 PM on 08/18/06 during the complaint investigation revisit _ survey accompanied by the Administrator, the following physical plant issues were identified: 25. Apartment #2: a. The entrance door was dirty. b. The common area walls were in need of paint. c. Bedroom #2: The room lacked window blinds and/or coverings for privacy. d. Bathroom: The bathroom jlacked window blinds and/or coverings for privacy. 26. Apartment #3: a. The entrance door was dirty. b. The common area walls were in need of paint and repair. The window of the common area lacked blinds and/or coverings for privacy. 1 of 2 the sofas located in the resident common area was torn and dirty. c. Bedroom #1: The room lacked window blinds and/or coverings for privacy. d. Bedroom #2: 1 of 4 of the drawers on a dresser was broken and in need of repair. 27.. Apartment #4: a. The entrance door was dirty and in need of repair. b. Multiple bed frames were stored in the resident common area. qc. Bedroom #2: The room lacked window blinds and/or coverings for privacy. The doorknob was missing; therefore, the resident's are unable to lock the door for privacy. d. Bathroom: Approximately 3 tiles over the tub/shower were missing. The toilet seat lid was detached from the toilet. ‘28. Apartment #5: a. The entrance door was dirty and the door frame was in need of repair. b. A black faux leather sofa had multiple tears. c. Bedroom #1: The room lacked window blinds and/or coverings for privacy. d. Bathroom: The tub was very dirty. The shower curtain was covered with mold. 29. Apartment #6: a. The entrance door was dirty. b. Bedroom #2: The wall located next to bed #2 showed signs of decay and mildew. The baseboards surrounding the perimeter of the room showed signs of decay from moisture. The ‘room lacked window blinds and/or coverings for privacy. c. ‘Bathroom: The toilet seat lid was detached from the toilet and lying on the floor next to the toilet and sink. The light fixture over the sink was missing a light bulb. 30. Apartment #8: a. The entrance door was dirty. b. Bedroom #1: The room lacked window blinds and/or coverings for privacy. The doorknob was missing enabling the resident of locking the door for privacy. 31. During an interview with Employee #1, it was reported that the bathroom of apartment #8 was inoperable. 32. During a tour of the dining room the surveyor observed a large hole in the wall over the double doors that divide the dining room and apartment #8. 33. During the exit conference conducted at approximately 12:30 PM, the Administrator acknowledged the findings. . 34. Upon tour of the facility conducted at approximately -12:00 PM on 08/18/06 during the complaint investigation revisit survey accompanied by the Administrator, it was noted that the air conditioning units were inoperable in Apartment #'s 3 and 4. 35. Upon observation during a tour of Apartment #6, it was noted the temperature control knob was missing off of the control panel of the air conditioning unit, which obstructs the residents! ability to adjust the air conditioning temperature to meet their own comfort level. 36. During the exit conference conducted at approximately 12:30 PM, the Administrator acknowledged the findings. This is an uncorrected deficiency from the survey of June 12, 2006 and August 18, 2007. 37. The mandated date of correction was designated as September 17, 2006. 38. A complaint investigation survey was conducted on October 10, 2006. Based on gbservation and interview, it was determined that the facility failed to ensure that the physical plant was clean and in good repair and that all appliances were in good working order. The findings include the following. 39. Upon tour of the facility conducted at approximately 10:15 AM on 10/10/06 during the complaint investigation revisit survey accompanied by Employee #1 and the Manager, the following physical plant issues were identified: . 40. Apartment #2: a. The common area walls were in need of paint. b. Bedroom #2: The room lacked window blinds and/or coverings for privacy. c. Bathroom: The bathroom light fixture was missing the original decorative covering. The light fixture was missing 1 out of 2 light bulbs. 41.. Apartment #3: a. The common area walls were in need of paint. b. The common area walls and the entrance door jam were in need of paint and repair. The window of the common area lacked blinds and/or coverings for privacy. A ladder was observed lying on the floor, which presented a potential "tripping" hazard. c. Bedroom #1: The room lacked window blinds and/or coverings for privacy. d. Bedroom #2: 1 of 4 of the drawers on a dresser was ‘broken and in need of repair. 42. Apartment #4: a. The common area walls were in need of paint. b. A shower chair and bedside commode chair were stored in the resident common area. c. Bedroom #2:: The room lacked window blinds and/or coverings for privacy. The doorknob was missing; therefore, the resident's are unable to lock the door for privacy. d. Bathroom: Approximately 3 tiles over the tub/shower were missing. The light fixture over the sink was missing a light bulb. 121 43. Apartment. #6: a. The common area walls were in need of paint. b. Bedroom #2: The wall located next to bed #2 showed signs of multiple cracks. The walls surrounding the perimeter of the room showed signs of decay from moisture. c. Bathroom: The toilet seat lid was detached from the toilet and lying on the floor next to the toilet and sink. The light fixture over the sink was missing a light bulb. The grouting around the perimeter of the tub was in need of repair. 44. Apartment #8: a. The common area walls were in need of paint. b. Bedroom #1: The room lacked window blinds and/or coverings for privacy. The doorknob was missing enabling the resident of locking the door for privacy. There was a large hole in the closet door. 4 out of 5 of the drawers on a dresser were broken and in need of repair. c. During a tour of the dining room the surveyor observed a large hole in the wall over the double doors that divide the dining room and apartment #8. d. A white faux leather sofa, located in the common area, contained several holes and tears. . 45. During the exit conference conducted at approximately 11:00 AM, Employee #1 and the Manager acknowledged the findings. 12 46. Upon tour of the facility conducted at approximately 10:15 AM on 10/10/06 during the complaint investigation revisit survey accompanied by Employee #1 and the Manager, it was noted that the air conditioning units were inoperable in Apartment #'s 3 and 4. 47.. Upon observation during a tour of Apartment #6, it was noted the temperature control knob was missing off of the control panel of the air conditioning unit, which obstructs the residents! ability to adjust the air conditioning temperature to meet their own comfort level. 48. During the exit conference conducted at approximately 11:00 AM, Employee #1 and the Manager acknowledged the findings. This is an uncorrected deficiency from’ the surveys of June 12, 2006 ‘and August 18, 2006. 49. Based on the foregoing facts, Tropical Haven violated Rule 58A-5.023(1) (b), Florida Administrative Code, herein classified as a repeat and uncorrected Class III violation. This violation warrants a fine of $1,000 per day of violation pursuant to Sections 429.19(2) (c) and 429.19(4), Florida Statutes (2006). The total fine was calculated from the mandated date of correction (9/17/06) to the date of the follow- up survey (10/10/06) giving rise to a fine of $23,000.00. 13 FACTORS RELEVANT TO RULE 429.19(3), FLORIDA STATUTES (2006) (a). In regards to the gravity of the violation, including the probability that death or serious physical or emotional harm to a resident will result or has resulted, the severity of the action or potential harm, and the extent to which the provisions of the applicable laws or rules were violated, the Agency has considered the following factors: Several of the rooms lacked window blinds which did not allow residents to have privacy in their bedrooms. There were doorknobs missing on some of the doors which did not permit the residents to be able to lock the doors of their rooms. This hindered the privacy and feeling of being able to sleep securely. Additionally, the temperature control doorknobs on air conditioners were missing which obstructed the residents from being able to adjust the temperature in their rooms. These factors threatened the "physical and emotional health, safety and security of the residents. (b) In regards to the actions taken by the owner or administrator to correct violations, the citations in question were cited on June 12, 2006 and found uncorrected on August 18, 2006 and again on October 10, 2006. 14 (c) In regards to previous violations, Tropical Haven has been cited as follows: 1. For one Class. III .and’ two Class IV violations for failure to submit. a preliminary report, a report within 15 days, and use of half bed rails as physical restrains on April 30, 2006. The facility was fined $700.00 for these violations. 2. For three Class III violations on August 18, 2006 related to physical plant, maintenance. of appliances and failure ‘to comply with dietary standards. . The facility was fined $1,500.00 for these violations. (d) In regards to the financial benefit to the facility of for ‘committing or continuing the violation, it is the Agency’s position that by: delaying the needed repairs, the facility . : obtained a financial benefit. (e) The licensed capacity of the facility is presently 23 non-Oss residents. At the time of the violations, the licensed capacity was 13 OSS and 13 non-OSS residents. CLAIM FOR RELIEF WHEREFORE, the Agency requests the Court to order the following relief: 15 1. Enter a judgment in favor of the Agency for Health Care Administration against Tropical Haven on Count I. 2. Assess an administrative fine of $23,000.00 against Tropical Haven .on Count I for the violation cited above. 3. Assess. costs related to the investigation and prosecution of this matter, if the Court finds costs applicable. 4. Grant such other relief as this 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 (2006). Specific options for administrative action are set “out in the attached Election of Rights. All requests 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. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO RECEIVE A REQUEST FOR A HEARING WITHIN TWENTY-ONE (21) DAYS OF RECEIPT OF THIS COMPLAINT WILL RESULT IN AN ADMISSION OF THE FACTS ALLEGED IN THE COMPLAINT AND THE ENTRY OF A FINAL ORDER BY THE AGENCY. 16 IF YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY IN THIS MATTER QLta) SD), Rradespes ) Alba M. Rodriquez, ’Esq. Fla. Bar No.: 0880175 Assistant General Counsel Agency for Health Care Administration 8350 N.W. 52 Terrace - #103 Miami, Florida 33166 Copies furnished to: Diane Reiland Field. Office Manager Agency for Health Care Administration 5150 Linton Blvd. - Suite 500 Delray Beach, Florida 33484 (U.S.°Mail) Karen Davis Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) Assisted Living Facility Unit Program Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) 17 CERTIFICATE OF SERVICE EB ERVILCE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished by U.S. Certified Mail, Return Receipt Requested to Gary Smith, Administrator, Tropical Haven, 460 N. W. 4o% Court, Oakland Park, Florida 33309; Gary Smith, Registered Agent, 5540 Nn. W. 49th Way, Coconut Creek, Florida 33073 on this Tia day of OcTfoten ) , 2007. mOVIES) PY), Bods. ‘Alba M. Rodriquez, Esq. a y 18

Docket for Case No: 07-005151