STATE OF FLORIDA os AGENCY FOR HEALTH CARE ADMINISTRATIO! LPG HOME HEALTH CARE, LLC, Petitioner, AHCA No.: 2008011187 vs. DOAH No.: 08-5658 RENDITION NO.: AHCA-09- -S-OLC STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / FINAL ORDER Having reviewed the Notice of Intent to Deem Application Incomplete and Withdrawn from Further Review dated September 29, 2008, attached hereto and incorporated herein (Exhibit 1), and all other matters of record, the Agency for Health Care Administration (‘Agency’) has entered into a Settlement Agreement (Exhibit 2) with the parties 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. Upon full execution of this Agreement, the parties agree to the following: a. The Notice of Intent to Deem Application Incomplete and Withdrawn from Further Review is deemed superseded. b. The Petitioner's request for formal administrative proceedings is withdrawn. c Petitioner agrees that the administrator and the alternate administrator/director of nursing named in the application, Kimberly A. Clark, RN, and Carleen Noreus, RN, shall work the required number of hours for Petitioner to provide sufficient coverage for the operation of the home health agency as required by 59A-8.003 (10) and 59A-8.0095 (1) (a) 2, Florida Administrative Code and 400.476 (1) (a) Florida Statutes (2008). This provision is an essential element of this settlement and shall be a condition of licensure in the event that Petitioner otherwise meets all of the conditions and requirements for initial licensure. d. Petitioner agrees to pay $500.00 in administrative fees to the Agency within thirty (30) days of the entry of the Final Order. e. Upon the full execution of this Agreement, the Agency shall begin processing Petitioner’s application. f. Nothing in this Agreement shall prohibit the Agency from denying Petitioner's application for licensure based upon any statutory and/or regulatory provision, including, but not limited to, the failure of Petitioner to satisfactorily complete a survey reflecting compliance with all statutory and rule provisions as required by law. 3. Each party shall bear its own costs and attorney’s fees. 4. | The above-styled case is hereby closed. DONE and ORDERED this —27 day of —Canuary | 2009, in Tallahassee, Leon County, Florida. Secretary aith Care Administration Holly Benso Agency for 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: Pamela E. Green Alba M. Rodriguez, Esq. Representative LPG Home Health Care, LLC 7529 Santa Monica Drive Margate, Florida 33063 (U. S. Certified Mail) Assistant General Counsel Agency for Health Care Administration 8350 N. W. 52 Terrace - Suite 103 Miami, Florida 33166 (interoffice Mail) Jan Mills Agency for Health Care Administration 2727 Mahan Drive, Bldg #3, MS #3 Tallahassee, Florida 32308 (Interoffice Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive, Bldg #1, MS #9 Tallahassee, Florida 32308 (Interoffice Mail) Anne Menard Eleanor M. Hunter Manager Administrative Law Judge Home Care Unit Division of Administrative Hearings Agency for Health Care 1230 Apalachee Parkway Administration Tallahassee, Florida 32399 2727 Mahan Drive (U.S. Mail) 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 22 day of ~ONaaer Richard J. Shoop Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308 (850) 922-5873 ay . FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION CHARLIE CRIST HOLLY BENSON GOVERNOR Certified Article Number SECRETARY . : 4 : September 29, 2008 7eO 3901 F848 LOWS BE ew RECEIPT REQUESTED ‘ SENDERS RECORD Administrator LPG Home Health Care LLC 7529 Santa Monica Dr Margate, Fl 33063 File Number: 19966049 Case #: 2008011187 NOTICE OF INTENT TO DEEM APPLICATION INCOMPLETE AND WITHDRAWN FROM FURTHER REVIEW Your application for license is deemed incomplete and withdrawn from further consideration pursuant to Section 408.806(3)(b), Florida Statutes, which states that “Requested information omitted from an application for licensure, license renewal, or change of ownership, other than an inspection, must be filed with the agency within 21 days after the agency’s request for omitted information or the application shall be deemed incomplete and shall be withdrawn from further consideration and the fees shall be forfeited’. You were notified by correspondence dated May 16, 2008 to provide further information addressing identified apparent errors or omissions within twenty-one days from the receipt of the Agency’s correspondence. Our records indicate you received this correspondence by certified mail on May 19, 2008. As this requested information was not timely received by the Agency, your application is deemed incomplete and withdrawn from further consideration. The outstanding issues remaining for licensure are: 1. The applicant was requested to select a new administrator as the original proposed administrator did not qualify. The applicant submitted a resume for an RN who is currently a staff nurse in the emergency room at a local hospital. It was not evident that the individual would be available to be responsible for the day-to-day operations of the start up home health agency. The pertinent statutes and rules that apply include the following: Section 408.806 (1), Florida Statutes (F.S.), “An application for licensure must be made to the agency on forms furnished by the agency, submitted under oath, and accompanied by the appropriate fee in order to be accepted and considered timely. The application must contain information required by authorizing statutes and applicable rules...” Section 400.462 (1), F.S., “Administrator" means a direct employee, as defined in subsection (9), who is a licensed physician, physician assistant, or registered nurse licensed to practice in this state or an individual having at least 1 year of supervisory or administrative experience in home health care or in a facility licensed under chapter 395, under part II of this chapter, or under part I of chapter 429.” Section 59A-8.003 (10) (a) through (c), Florida Administrative Code (F.A.C.), “A home health agency has the following responsibility in terms of hours of operation: 2727 Mahan Drive, MS#34 Tallahassee, Florida 32308 Visit AHCA online at http://ahca.myfiorida.com Page 2 September 29, 2008 (a) The home health agency administrator and director of nursing, or their alternates, must be available to the public for any eight consecutive hours between 7:00 a.m. and6:00 p.m., Monday through Friday of each week, excluding legal and religious holidays. Available to the public means being readily available on the premises or by telecommunications. (b) When the administrator and the director of nursing are not on the premises during designated business hours, a staff person must be available to answer the phone and the door and must be able to contact the administrator and the director of nursing by telecommunications. This individual can be a clerical staff person. : (c) Ifan AHCA surveyor arrives on the premises to conduct an unannounced survey and the administrator, the director of nursing, or a person authorized to give access to patient records, are not availabJe on the premises they, or the designated alternate, must be available on the premises within an hour of the arrival of the surveyor. A list of current patients must be provided to the surveyor within two hours of arrival if requested.” : Section 594-8.003 (10) (e), F.A.C., “Failure to be available or to respond, as defined in paragraphs (a) through (c) above, will result in a $500 fine, pursuant to Section 400.474(1), F.S. A second incident will be grounds for denial or revocation of the agency license.” The. applicant was requested to select another alternate administrator as the original proposed individual did not meet qualifications. The applicant selected an RN for both the alternate administrator and director of nursing position and indicated the individual would work part time. The individual selected is currently a Clinical Manager in the emergéncy room for a local hospital. It was not evident that the individual would be available to the new start up home health agency as needed. : The pertinent statutes and rules that apply include the following: Section 408.806 (1), F.S., “An application for licensure must be made to the agency on forms furnished by the agency, submitied under oath, and accompanied by the appropriate fee in order to be accepted and considered timely. The application must contain information required by authorizing statutes and applicable rules...” Section 400.462 (1), F.S., “Administrator" means a direct employee, as defined in subsection (9), who is a licensed physician, physician assistant, or registered nurse licensed to practice in this state or an individual having at least 1 year of supervisory or administrative experience in home health care or in a facility licensed under chapter 395, under part II of this chapter, or under part I of chapter 429.” . Section 400.476 (1) (a), F.S., “ADMINISTRATOR.-- (a) An administrator may manage only one home health agency, except that an administrator may manage up to five home health agencies if all five home health agencies have identical ‘controlling interests as defined in s. 408.803 and are located within one agency geographic service area or within an immediately contiguous county. If the home health agency is licensed under this chapter and is part of a retirement community that provides multiple levels of care, an employee of the retirement community may administer the home health agency and up to a maximum of four entities licensed under this chapter or chapter 429 which all have identical controlling interests as defined in s. 408.803. An administrator shall designate, in writing, for each licensed entity, a qualified alternate administrator to serve during the administrator's absence.” Page 3 September 29, 2008 Section S9A-8.0095(1) (a) 2., F.A.C., “Administrator. (a) The administrator of the agency shall: 2. Designate, in writing a direct employee or an individual covered under a management company contract to manage the home health agency or an employee leasing contract, pursuant to Section 468.520, F.S., that provides the agency with full control over all operational duties and responsibilities to serve as an on-site alternate administrator during absences of the administrator. This person will be available during designated business hours, when the administrator is not available. Available during designated business hours means being readily available on the premises or by telecommunications. During the absence of the administrator, the on-site alternate administrator wil] have the responsibility and authority for the daily operation of the agency. The alternate administrator must meet qualifications as stated in Section 400.462(1), F.S.” Section 59A-8.003 (10) (a) through (c), F.A.C., “A home health agency has the following responsibility in terms of hours of operation: (a) The home health agency administrator and director of nursing, or their alternates, must be available to the public for any eight consecutive hours between 7:00 a.m. and6:00 p.m., Monday through Friday of each week, excluding legal and religious holidays. Available to the public means being readily available on the premises or by telecommunications. (b) When the administrator and the director of nursing are not on the premises during designated business hours, a staff person must be available to answer the phone and the door and must be able to contact the administrator and the director of nursing by telecommunications. This individual can be a clerical staff person. (c) If an AHCA surveyor arrives on the premises to conduct an unannounced survey and the administrator, the director of nursing, or a person authorized to give access to patient records, are not.available on the premises they, or the designated alternate, must be available on the premises within an hour of the arrival of the surveyor. A list of current patients must be provided to the surveyor within two hours of arrival if requested.” Section 59A-8.003 (10) (e), F.A.C., “Failure to be available or to respond, as defined in paragraphs (a) through (c) above, will result in a $500 fine, pursuant to Section 400.474(1), F.S. A second incident will be grounds for denial or revocation of the agency license.” The applicant did not submit proof of professional liability insurance coverage as requested in the omission letter. The applicant submitted a binder for the professional liability coverage. The pertinent statutes and rules that apply include the following: Section 408.806 (1), F.S., ‘An application for licensure must be made to the agency on forms furnished by the agency, submitted under oath, and accompanied by the appropriate fee in order to be accepted and considered timely. The application must contain information required by authonzing statutes and applicable rules...” Section 400.471 (3) (b), F.S., “In addition to the requirements of s. 408.810, the home health agency must also obtain and maintain the following insurance coverage in an amount of not less " than $250,000 per claim, and the home health agency must submit proof of coverage with an imitial application for licensure and with each application for license renewal: (a) Malpractice insurance as defined in s. 624.605(1)(k). Page 4 oe September 29, 2008 EXPLANATION OF RIGHTS Pursuant to Section 120.569, F.S., you have the right to request an administrative hearing. In order to obtain a formal proceeding before the Division of Administrative Hearings under Section 120.57(1), F.S., your request for an administrative hearing must conform to the requirements in Section 28-106.201, Florida Administrative Code (F.A.C), and must state the material facts you dispute. SEE ATTACHED ELECTION AND EXPLANATION OF RIGHTS FORMS. _ - . f Cg eI. Db. sdk Anne Menard, Manager Home Care Unit cc: Agency Clerk, Mail Stop 3 Legal Intake Unit, Mail Stop 3 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION LPG HOME HEALTH CARE, LLC, Petitioner, v. AHCA No.: 2008011187 DOAH No.: 08-5658 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT Respondent, State of Florida, Agency for Health Care Administration (hereinafter the Agency”), through its undersigned representatives, and Petitioner, LPG Home Health Care, LLC (hereinafter “Petitioner”), 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: WHEREAS, the Petitioner is an applicant for home health agency licensure pursuant to Chapter 400, Part III, Florida Statutes (2007), Section 20.42, Florida Statutes (2007), Chapter 408, Part II, Florida Statutes (2007), and Chapter 59A-8, Florida Administrative Code; and EXHIBIT tabbies* a WHEREAS, the Agency has jurisdiction by virtue of being the regulatory ‘and licensing authority over licensure sought by Petitioner; and WHEREAS, the Agency served the Petitioner with a Notice of Intent to Deem Application Incomplete and Withdrawn from Further Review notifying the party of its intent to deny Petitioner’s application for licensure; and WHEREAS, the Petitioner requested a formal administrative hearing by filing an election of rights form or by petition; and WHEREAS, the parties have agreed that a fair, efficient, and cost effective resolution of this dispute would avoid the expenditure of substantial sums to litigate the dispute; and WHEREAS, the parties stipulate to the adequacy of considerations exchanged; and WHEREAS, the parties have negotiated in good faith 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 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. Page 2 of 7 3. Upon full execution of this Agreement, Petitioner agrees to a withdrawal of its request for an administrative proceeding; agrees to waive any and ali proceedings and appeals to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), a formal proceeding under Subsection 120.57(1), 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 further 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 Agreement. 4. Upon full execution of this Agreement, the parties agree to the following: a. The Notice of Intent to Deem Application Incomplete and Withdrawn from Further Review is deemed superseded. b. The Petitioner’s request for formal administrative proceedings is withdrawn. c. Petitioner agrees that the administrator and the alternate administrator/director of nursing named in the application, Kimberly A. Clark RN and Carleen Noreus, RN, shall work the required numbers of hours for Petitioner to provide sufficient coverage for the operation of the home health agency Page 3 of 7 as required by 59A-8.003 (10) and 59A-8.0095 (1) (a) 2, Florida Administrative Code and 400.476 (1) (a) Florida Statutes (2008). This provision is an essential element of this settlement and shall be a condition of licensure .in the event that Petitioner otherwise meets all of the conditions and requirements for initial licensure. d. Petitioner agrees to pay $500.00 in administrative fees to the Agency within thirty (30) days of the entry of the Final Order. e. Upon the full execution of this Agreement, the Agency shall begin processing Petitioner’s application. £. Nothing in this Agreement shall prohibit the Agency from denying Petitioner’s application for licensure based upon any statutory and/or regulatory provision, including, but not limited to, the failure of Petitioner to satisfactorily complete a survey reflecting compliance with all statutory and rule provisions as required by law. 5. Venue for any action brought to interpret, challenge or enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie solely in the Circuit Court in Leon County, Florida. 6. By executing this Agreement, the Petitioner admits the allegations raised in the Notice of Intent to Deem application Incomplete and Withdrawn from Further Review referenced herein. Page 4 of 7 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 case. 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. The Petitioner for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the Agency and its agents, representatives, and attorneys of 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 the Petitioner or related or resulting organizations. 11. This Agreement is binding upon all parties herein and those identified in the aforementioned paragraph of this Agreement. 12. In the event that Petitioner is or was a Medicaid provider, this settlement does not prevent the Agency from seeking Medicaid overpayments or from imposing any sanctions Page 5 of 7 pursuant to Rule 59G-9.070, Florida Administrative Code. This agreement does” not prohibit the Agency from taking action regarding Petitioner’s Medicaid provider status, conditions, requirements or contract. 13. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. Petitioner’s representative has the capacity to execute this Agreement and has done so without the advice of counsel. The Petitioner understands that it has the right to consult with counsel and has knowingly and freely entered into this Agreement without exercising its right to consult with counsel. The Petitioner fully understands that counsel for the Agency represents solely the Agency and Agency counsel has not provided legal advice to or influenced the Petitioner in its decision to enter into this Agreement. 14. This Agreement contains the entire understandings and agreements of the parties. 15. This Agreement supersedes any prior oral or written agreements between the parties. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void. 16. All parties agree that a facsimile signature suffices for an original signature. Page 6 of 7 The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. (a, < eZ BE. Green Blizabe\h Dudek Deputy Secretary Representative Diviston of Health Quality LPG Home Health Care, LLC Assurance. 7529 Santa Monica Drive Agency for Health Care Margate, Florida 33063 Administration 2727 Mahan Drive Tallahassee, Florida 32308 Dated: W271 2208 Dated: [2 (30 (£200 € lee Gi thas 7, Kedocque Justin Senior, Esq. Alba M. Rodriguéz, sq. Acting General Counsel Assistant General Counsel Agency for Health Care Agency for Health Care Administration Administration 2727 Mahan Drive 8350 N.W. 52 Terrace - #103 Tallahassee, Florida 32308 Miami, Florida 33166 Dated: (27/09 — Dated: ({- G- G8 Page 7 of 7

Docket for Case No: 08-005658