STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, AHCA No.: 2009007229 Return Receipt Requested: v. 7009 0080 0000 0586 7376 7009 0080 0000 0586 7383 UNLIMITED HOME CARE. INC. d/b/a UNLIMITED HOME CARE INC., Respondent. ADMINISTRATIVE COMPLAINT COMES NOW the State of Florida, Agency for Health Care Administration (“AHCA”), by and through the undersigned counsel, and files this administrative complaint against Unlimited Home Care Inc. d/b/a Unlimited Home Care Inc. (hereinafter “Unlimited Home Care Inc.”), pursuant to Chapter 400, Part III, and Section 420.60, Florida Statutes (2008), and herein alleges: NATURE OF THE ACTION 1. This is an action to impose an administrative fine of $5,000.00 pursuant to Section 400.484, Florida Statutes (2008), for the protection of public health, safety and welfare. Filed March 1, 2010 12:30 PM Division of Administrative Hearings. JURISDICTION AND VENUE 2. AHCA has ‘jurisdiction pursuant to Chapter 400, Part III, Florida Statutes (2008). 3. Venue lies pursuant to Rule 28.106.207, Florida Administrative Code. PARTIES 4. AHCA is the regulatory authority responsible for . licensure and enforcement of all applicable statutes and rules governing home health agencies, pursuant to Chapter 400, Part IIt, Florida Statutes (2008), and Chapter 59A-8 Florida Administrative Code. 5. Unlimited Home Care Inc. operates a home health agency located at 342 E. 9° street, Suite 201, Hialeah, Florida 33010. Unlimited Home Care Inc. is licensed as a home health agency under license number 299992084. Unlimited Home Care Inc. 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 UNLIMITED HOME CARE INC. FAILED TO PROVIDE CARE ACCORDING TO THE PLAN OF CARE. SECTION 400.462(2), FLORIDA STATUTES SECTION 474(5), FLORIDA STATUTES RULE 59A-8.020(1), FLORIDA ADMINISTRATIVE CODE. (ACCEPTANCE OF PATIENTS OR CLIENTS STANDARDS) UNCLASSIFIED DEFICIENCY 6. AHCA re~alleges and incorporates paragraphs (1) through (5) as if fully set forth herein. 7. Unlimited Home Care Inc. was cited with one (1) deficiency as a result of a licensure survey that was conducted on April 23, 2009 8. A licensure survey was conducted on April 23, 2009. Based on record review and interview, it was determined that the agency failed to provide care according to the plan of care for 6 of 8 sampled patients (#1, #2, #7, #8, #9, #11). The findings include the following. 9. Clinical record review of sampled patient #1 revealed a start of care date of 05/12/07 (certification period: 03/02/09 to 04/30/09) and an admitting diagnosis of Diabetes Mellitus type 2 The orders for discipline and treatment in locator 21 of the Plan of care dated 03/02/09 was physical therapy 3xweek for 4 weeks and 2xweek for 1 week. Further review of the clinical record revealed a prescription from the physician dated 02/26/09 for physical therapy and occupational therapy evaluation and treatment. There was no documented evidence the occupational therapy evaluation was performed and no documented evidence the physician was notified. 10. Interview with the director of nursing and the administrator on 04/22/09 at 2:p.m. confirmed the findings. He/She states she relied on the physical therapist to advise her on which portion of the therapy services need to be done and she went along with their advice and never thought she needed to consult with the physician. 11. Clinical record review of sampled patient #2 revealed a start of care date of 11/06/08 (certification period: 03/06/09 to 05/04/09) and an admitting diagnosis of Diabetes Mellitus type 2. The orders for discipline and treatment in locator 21 of the Plan of Care dated 03/06/09 was occupational therapy 2xweek for 1 week and 3 x week for 4 weeks. Further review of the clinical record revealed a prescription from the physician dated 03/02/09 for physical therapy and occupational therapy evaluation and treatment. There was no documented evidence the physical therapy evaluation was performed and no documented evidence the physician was notified. 12. Interview with the director of nursing and the administrator on 04/22/09 at 2:p.m. confirmed the findings. He/She states she relied on the physical therapist to advise her 4 on which portion of the therapy services need to be done and she went along with their advice and never thought she needed to consult with the physician. 13. Clinical record review of sampled patient #7 revealed a start of care date of 12/14/08 (certification period: 02/12/09 to 04/12/09) and an admitting diagnosis of Diabetes Mellitus type 2. The orders for discipline and treatment in locator 21 of the Plan of care dated 02/12/09 was physical therapy 2 x week for 1 week and 3 x week for 4 weeks. Further review of the clinical record revealed a prescription from the physician dated 02/09/09 for physical therapy and occupational therapy evaluation and treatment. There was no documented evidence the physical therapy evaluation was performed and no documented evidence the physician was notified. “14, Interview with the director of nursing and the administrator on 04/22/09 at 2:p.m. confirmed the findings. He/She states she relied on the physical therapist to advise her on which portion of the therapy services need to be done and she went along with their advice and never thought she needed to consult with the physician. 15. Clinical record review of sampled patient #8 revealed a start of care date of 03/12/09 (certification period: 03/12/09 to 05/10/09) and an admitting diagnosis of Encounter Occupation Tx. The orders for discipline and treatment in locator 21 of the Plan of care dated 03/12/09 was occupational therapy 3 x week for 4 weeks and 2 x week for 1 week. Further review of the clinical record revealed a prescription from the physician dated 03/11/09 for physical therapy and occupational therapy evaluation and treatment. There was no documented evidence the physical therapy evaluation was performed and no documented evidence the physician was notified. 16. Interview with the director of nursing and _ the administrator on 04/22/09 at 2:p.m. confirmed the findings. He/She states she relied on the physical therapist to advise her on which portion of the therapy services need to be done and she went along with their advice and never thought she needed to consult with the physician. 17. Clinical record review of sampled patient #9 revealed a start of care date of 03/21/09/ (certification period: 03/21/09 to 05/19/09) and an admitting diagnosis of Encounter Occupation Tx. The orders for discipline and treatment in locator 21 of the Plan of care dated 03/21/09 was occupational therapy 3 x week for 4 weeks and 2 x week for 1 weeks. Further review of the clinical record revealed a prescription from the physician dated 03/ 20/09 for physical therapy and occupational therapy evaluation and treatment. There was no documented evidence the physical therapy evaluation was performed and no documented evidence the physician was notified. 18. Interview with the director of nursing and the administrator on 04/22/09 at 2:p.m. confirmed the findings. He/She states she relied on the physical therapist to advise her on which portion of the therapy services need to be done and she went along with their advice and never thought she needed to consult with the physician. 19. Clinical record review of sampled patient #11 revealed a start of care date of 03/07/07 (certification period: 02/24/09 to 04/24/09) and an admitting diagnosis of Diabetes Mellitus Type 2. The orders for discipline and treatment in locator 21 of the Plan of care dated 02/24/09 was occupational therapy 2 x week for 1 week and 3 x week for 4 weeks. Further review of the clinical record revealed a prescription from the physician dated 02/22/09 for physical therapy and occupational therapy evaluation and treatment. There was no documented evidence the physical therapy evaluation was performed and no documented evidence the physician was notified. 20. Interview with the director of nursing and _ the administrator on 04/22/09 at 2:p.m. confirmed the findings. He/She states she relied on the physical therapist to advise her “on which portion of the therapy services need to be done and she went along with their advice and never thought she needed to consult with the physician. 21. Section 400.474(5), Florida Statutes, provides that “the agency shall impose a fine of $5,000.00 against a home health agency that demonstrates a pattern of failing to provide a service specified in the plan of care for that patient”. ... A pattern may be demonstrated by a showing of at least three incidents, regardless of the patient or service, where the home health agency did not provide a service specified in a written agreement or plan of care during a 3-month period. 22. Based on the foregoing facts, Unlimited Home Care Inc. violated Section 400.462(2), Florida Statutes, and Rule 59A- 8.020(1), Florida Administrative Code, herein classified as an unclassified deficiency, which warrants an assessed fine of $5,000.00 pursuant to Section 400.474(5), Florida Statutes. CLAIM FOR RELIEF WHEREFORE, the Agency requests the Court to order the following relief: 1. Enter a judgment in favor of the Agency for Health Care Administration against Unlimited Home Care Inc. on Count I. 2. Assess against Unlimited Home Care Inc. an administrative fine of $5,000.00 on Count I for the violation cited above. 3. Assess costs related to the investigation and prosecution of this matter, if applicable. 4. Grant such other relief as the court deems is just and proper on Count fT. Respondent is notified that it has a right to request an administrative hearing pursuant to Sections 120.569 and 120.57, Florida Statutes. 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. IF YOU WANT TO HIRE AN ATTORNEY, YOU HAVE THE RIGHT TO REPRESENTED BY AN ATTORNEY IN THIS MATTER Whwr ner ourdes:A. Naranjo, Esq Fla. Bar No.: 997315 Assistant General Counsel Agency for Health Care Administration 8350 N.W. 52 Terrace - #103 Miami, Florida 33166 Copies furnished to: R. Steve Emling Field Office Manager Agency for Health Care Administration 8355 N. W. 53° Avenue Miami, Florida 33166 (U.S. Mail) Finance and Accounting Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) Home Health Agency Unit Program Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) 10 BE 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 Maria Bergolla, Administrator, Unlimited Home Care Inc., 342 EB. 9% Street, Suite 201, Hialeah, Florida 33010; Lorell Bergola, Registered Agent, 342 E. 9 Street, Suite 201, Hialeah, ’ Florida 33010 on this Bo day of Yor , 2009. Arcee Lourdes A. Naranjo, Es 11 | SENDER: COMPLETE THIS SECTION ‘COMPLETE THIS SECTION ON DELIVERY ® Complete items 1, 2, and 3. Also complete A Signature item 4 If Restricted Delivery Is desired. 5 Agant ® Print your name and address on the reverse Addressee 3 so that we can return the card to you. . CG ap Pelivery { £ @ Attach this card to the back of the mailpiece, f , Ady bg te 3 g ig Postage | $ or on the front If space parts. D.4s dolivery address different from item 1? C1 Yes * 4, Article Addressed to: IFYES, enter delivery address below: [No Certified Fee Haait. Rurgote. Vlad Vor. Com, dae. 440. £Ody Mint - Suile2or Wieboak {Oorifus 335016 * By Conteg Mell 1D express Mall T Registered 2 Return Recelptifor Merchandise C1 Insured Mail (1 6.0.0. Return Receipt Fee Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees C1 Yes 7009 060 O800 O58) 7376 102595-02-M-1540 i SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON'DELIVERY & Compiete Items 1, 2, and 3, Also complete A. Signature i! © item 4 if Restricted Delivery Is desired. —-«<<" a Print your name and address on the reverse so that we can return the card to you. * Wl Attach this card to the back of the mailpiece, or on the front if space permits, © Agent C Addressee C, Dat of Delivery yf af 24 D. {6 delivery &ddress different from item 1? [1 Yes If YES, enter delivery address below: [1 No Certified Fee Return Recelpt Fea (Endorsement Required) 1. Article Addressed to: dori. Angda Sh ESuw Atak - Gudtorn Viabook, FLoides 32010 Restricted Delivery Fe (Endorsement Requtired) 3. Service Typs Cl Certified Mall 1 Express Mail Cl Registered G Return Receipt! for Merchandlse C1 insured Mail ~— C1. G.0.D. “ — ** ted Delivery? (Extra Fee) T Yes 4b 7383 7009 0080 M000 O58b 738 This W176 7009 0040 9000 058, 7383 (Transfer from service label) F PS Form 3811, February 2004 Domestic Return Receipt Ga un Cormpies 102695-02-M-1540 '

Docket for Case No: 10-001003