OF Sa33 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. Case No. 2007009208 R.K. II, INC., d/b/a HELPING HANDS OF NORTH FLORIDA, Respondent. / ADMINISTRATIVE COMPLAINT COMES NOW the Petitioner, State of Florida, Agency for Health Care Administration (hereinafter “the Agency”), by and through its undersigned counsel, and files this Administrative Complaint against the Respondent, RK III Inc., d/b/a Helping Hands of North Florida. (hereinafter “the Respondent”), pursuant to §§ 120.569 and 120.57, Fla. Stat. (2007), and alleges: NATURE OF THE ACTION This is an action to revoke the Respondent’s license to operate a Nurse Registry pursuant to §§ 400 Part III and 408, Part I Fla. Stat. (2007) and Fla. Admin. Code R. 59A-18. JURISDICTION AND VENUE 1. The Court has jurisdiction over the subject matter pursuant to §§ 120.569, 120.57, 400, Part III, and 408, Part II, Fla. Stat. (2007). 2. The Agency has jurisdiction over the Respondent pursuant to. §§ 20.42, 120.60, 400, Part ITI, and 408, Part II, Fla. Stat. (2007). 3. Venue lies pursuant to Fla. Admin. Code R. 28-106.207. PARTIES 4. The Agency is the regulatory body responsible for the licensure of nurse registries and the enforcement of all applicable federal and state regulations, statutes and rules, governing nurse registries pursuant to § 400, Part III, Florida Statutes (2007), and Fla. Admin. Code R. 594-18. The Agency is authorized to deny, revoke or suspend the license of, or impose an administrative fine against, a nurse registry, for violations of the applicable federal and state regulations, statutes and rules, pursuant to §§ 400.506, and 408.815(1)(c), Fla. Stat. (2007). 5, The Respondent is a Florida licensed nurse registry (License Number 30211254), operates a nurse registry located at 2441 NW 43” Street, Suite 3B, Gainesville, Florida 32606, and was at all times material required to comply with the applicable federal and state regulations, statutes and rules. | COUNT I 6. The Agency re-alleges and incorporates by reference paragraphs 1 through 5. 7. On July 27, 2007, the Agency conducted an unannounced annual survey for licensure of the Respondent and the Respondent’s facility. The registry is not in compliance with §§ 400 Part III, and 408, Part II, Fla. Stat., and Fla. Admin. Code R. 59A-18. 8. Based upon observation and interview, the Respondent failed to display, post or provide their license. The failure to display the license has the potential for future clients not to be able to ensure the facility is licensed. The Agency’s surveyor’s findings were as follows: The entry to the registry office on 7/27/2007 at 1:00 PM revealed no evidence of the registry's license. The administrator of the registry was not available at that time. An interview conducted on 7/27/2007 at 1:30 PM with the law firm representing the registry revealed that all registry records, including the license, were seized by the Federal Bureau of Investigation in approximately May 2007. 9. An interview with the administrator conducted on 7/27/2007 at 2:45 PM revealed that the registry does not have a paper copy of the license as it was reported by the law firm representative as having been seized by the Federal Bureau of Investigation, along with all other registry records. Further interview with the administrator revealed that the registry bas not attempted to attain a copy of the license from the state. The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 10. IL. The above constitutes a violation of Fla. Admin. Code R. S9A-18.004(2). COUNT I yy he Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Count J as if fully set forth herein. 12. Based on interview, the Respondent did not have evidence of financial stability of the nurse registry operations. A failure to provide financial documents has the potential for financial instability to go undetected which may effect the services the registry provides. The Agency’s surveyor’s findings were as follows: 13. An interview conducted on 7/27/2007 at 1:30 PM with the law firm representative representing the registry revealed that all registry records were seized by the Federal Bureau of Investigation in approximately May 2007. An interview with the administrator conducted 7/27/2007 at 2:45 PM revealed that all registry records had been seized by the Federal Bureau of Investigation, along with all records maintained on the hard drive of their computer system in approximately May, 2007. A further interview with the administrator revealed that the registry has not attempted to reconstruct its financial records. The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 14. The above constitutes a violation of § 408.810(8) and (9), Fla. Stat. (2007), and Fla. Admin. Code R. 59A-18,004(8). COUNT IL 15. The Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Counts I and II as if fully set forth herein. 16, Based on an interview the registry failed to have patient's records and employee records available for the Agency's inspection. A failure to have records pertaining to the operation and function of the registry has the potential for untrained/unscreened employees to be providing care to patients. A failure to have patients’ Plan of Care records has the potential for inappropriate care and services being rendered to the patients, The Agency’s surveyor’s findings were as follows: An interview with the administrator conducted on 7/27/2007 at 3:00 PM revealed that all registry records were seized in approximately May 2007 by the Federal Bureau of Investigation. Further interview revealed that the registry has not reconstructed any of the missing documents/records. 17. The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 18. The above constitutes a violation of Fla. Admin. Code R. 59A-18.006. COUNT IV 19. The Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Counts L TJ and If as if fully set forth herein. 20, Based on an interview the registry failed to have records available for the Agency’s inspection. A failure to have records pertaining to the operation and function of the registry has the potential for untrained/unscreened employees to be providing care to the patients and inappropriate care to be given to patients because the staff is unable to obtain the patients’ Plan of Care. The Agency’s surveyor’s findings were as follows: An interview with the administrator conducted on 7/27/2007 at 3:00 PM revealed that all registry records were seized approximately May 2007 by the Federal Bureau of Investigation. Further interview with the administrator revealed that the registry has not reconstructed any of the missing documents/records, as they are only attempting to retrieve the documents/records which had been confiscated. 21. .The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 22. The above constitutes a violation of Fla. Admin. Code R. 59A-18.015(2), and Fla. Admin. Code R. 59A-18.004(11). COUNT V 23. The Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Counts I, II, Il] and IV as if fully set forth herein. 24. Based on record review and interview, the registry failed to provide documentation of policies and procedures of accepting patients for services. Further, the registry failed to present contracts and agreements with patients for services. A failure to have policies and procedures in place has the potential for mappropriate admittance to the registry for services . which may not be able to be provided by the registry safely. The Agency’s surveyor’s findings were as follows: A review of registry records revealed no evidence of policies and procedures for admitting patients for services to be rendered by the registry. An interview with the administrator conducted 7/27/2007 at 3:00 PM revealed they did not have copies of the registry's policies and procedures available for Agency review. Further interview with the administrator revealed a statement by the administrator that all of the registry's records were seized by the Federal Bureau of Investigation in approximately May 2007 and they had not recreated any of their policies and procedures. According the interview, the registry was attempting to regain their records, but has not been successful. 25. The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 26. The above constitutes a violation of Fla. Admin. Code R. 59A-18.010. COUNT VI 27. The Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Counts I, II, IH, TV and V as if fully set forth herein. 28, Based on record review and interview, the registry failed to provide documentation that patients had been informed of their rights to report complaints, abuse, neglect or exploitation, and had been provided the central abuse hotline number. A failure to provide the abuse telephone number to patients has the potential for patients not reporting if they are in an abusive or exploitative situation. The Agency’s surveyor’s findings were as follows: A review of registry records revealed no documented evidence of any type of information or documents that are provided to patients at the time of admission for services. The registry could not provide copies of contracts or admission agreements with the patients. An interview conducted with the administrator at 2:45 PM on 7/27/2007 revealed that all of the registry's records including the computer hard drive information had been seized by the Federal Bureau of Investigation in approximately May 2007. Further interview with the administrator revealed that "Senior Services" from . each county the registry serves "should" have copies of admission agreements/contracts, but they had not obtained a copy of them for their own records. 29, The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 30. The above constitutes a violation of § 408.810(5)(a), Fla. Stat. (2007). COUNT Vil 31. The Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Counts I, 1, Til, IV, V and VI as if fully set forth herein. 32. Based on record review and interview, the registry failed to provide documentation to demonstrate that patient requested Registered Nurse (RN) visits are being rendered. Failure to provide documentation of the RN visits may result in changes, in patient care, made by the patients’ physicians to go unnoticed and the patients to receive inappropriate care. The Agency’s surveyor’s findings were as follows: A review of registry records failed to reveal any documented evidence of patients being visited by an RN. An interview conducted with the administrator at 2:45 PM on 7/27/2007 revealed that all records including computer hard drive information had been seized by the Federal Bureau of Investigation in approximately May, 2007. Further interview with the administrator revealed that the registry did not start new files for their patients, when their files had been confiscated. 33. The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 34. The above constitutes a violation of § 400.506(6), Fla. Stat. (2007). COUNT VIIt 35. The Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Counts I, I, Ill, IV, V, VI and VII as if fully set forth herein. .36. Based on record review and interview, the registry failed to provide CNA/HHA (Certified Nursing Assistant/Home Health Aid) documentation of written progress on patients, evidence of training on these employees, or evidence of current CPR (Cardiopulmonary Resuscitation) training. Failure to have documentation of employee training and CPR certification has the potential for inappropriate care given to residents and additionally has the potential to delay care in an emergency situation. The Agency’s surveyor’s findings were as follows: A review of registry records revealed no evidence of personnel records or training records on any employee. 37. The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 38. The above constitutes a violation of Fla. Admin. Code R. 59A-18.0081. COUNT IX 39. The Agency re-alleges and incorporates by reference paragraphs 1 through 5 and Counts I, II, IL, IV, V, VI, VIL, and VIII as if fully set forth herein. 40. Based on record review and interview, the registry failed to provide the policy and procedure for identifying special needs of clients in case of emergency, failed to provide evidence that the registry had assessed its clients for any special assistance needs in the event of an emergency, and failed to provide evidence of having contacted the local Emergency Management Agency as to registration of any special needs patients. A failure to assess patients for special needs during an emergency has the potential for adverse health consequences including death in the event of a disaster. The Agency’s surveyor’s findings were as follows: A review of registry records failed to revealed any documentation for special needs assessments of clients, policy and procedure for assessing the clients, and documentation that the Emergency Management Agency had been contacted regarding any special needs their clients may have. An interview with the administrator conducted 7/27/2007 at 3:00 PM revealed that all registry records were seized approximately May, 2007 by the Federal Bureau of Investigation. Further interview with the administrator on the same date and time revealed that the registry has not reconstructed any of the missing documents/records. 41, The Agency provided the Respondent with a mandated correction date of August 27, 2007, for this cited violation of law. 38. The above constitutes a violation of § 400.506(11) and (12), Fla. Stat. (2007). CLAIM FOR RELIEF WHEREFORE, the State of Florida, Agency for Health Care Administration, respectfully requests that this court pursuant to §§ 400, Part III and 408, Part II, Fla. Stat. (2007): (A) Make factual and legal findings in favor of the Agency on Counts I, Il, HI, IV, V, VI, VII, VIII and Count IX; (B) Revoke Respondent’s Nurse Registry License number 30211254; (C) Assess attorney’s fees and costs; and (D) Grant all other general and equitable relief allowed by law. Respondent is notified that it has a right to request an administrative hearing pursuant to Section 120.569, Florida Statutes. Specific options for administrative action are set out in the attached Election of Rights form. All requests for hearing shall be made to the attention of Richard Shoop, Agency Clerk, Agency for Health Care Administration, 2727 Mahan Drive, MS #3, Tallahassee, Florida 32308, (850) 922-5873. RESPONDENT IS FURTHER NOTIFIED THAT THE FAILURE TO REQUEST A HEARING WITHIN 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. Respectfully submitted this i | day of October, 2007. ( ys if it orrain q. Agency for Health Care Administration 2727 Mahan Drive, MS # 3 Tallahassee, Florida 32308 (850) 922-5873 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been served by U.S. Certified Mail, Return Receipt No. 7004 2890 0000 5526 7636 to Owner R.K.HI, Inc., 506 NW 4" Street, Suite 100, Jasper, Florida 32052, by U.S. Certified Mail, Return Receipt No. 7004 2890 0000 5526 7643 to Administrator Cassidy Chirino, Helping Hands of North Florida, 2441 NW 43” Street, Suite 3B, Gainesville, Florida 326106 and by U.S. Certified Mail, Return Receipt No: 2007 2890 0000 5526 7650 to Registered Agent Robert A. Krasnow, 506 NW 45" Street, Jasper, Florida 32052 on this tb day of October, 2007. Lorraine M. Novak, Esquire Copy furnished to: Kris Mennella, FOM 10

Docket for Case No: 07-005233