STATE OF FLORIDA 2020 DEC l 7 P 2: 3 I

AGENCY FOR HEALTH CARE ADMINISTRATION

RICHLAND RETIREMENT SENIOR HOME, INC.,

Petitioner,

V.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Respondent.

/

DOAH Case No. 20-0562 AHCA No. 2019015055

License No. 9475

File No. 11964927

Facility Type: Assisted Living Facility

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

V.

RICHLAND RETIREMENT SENIOR HOME, INC.,

DOAH Case No. 20-1082 AHCA Nos. 2019005087

2019010945

2019010949

2019010955

Respondent.

I

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

V.

DOAH Case No. 20-2638 AHCA No. 2019017715

RENDITION NO.: AHCA· 1-0 • 'o '---\ -S· -S-OLC

RICHLAND RETIREMENT SENIOR HOME, INC.,

Respondent.

I

Filed January 13, 2021 4:35 PM Division of Administrative Hearings

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

V. AHCA No. 2020012170

RICHLAND RETIREMENT SENIOR HOME, INC.,

Respondent.

/

FINAL ORDER

Having reviewed the Administrative Complaint, and all other matters of record, the Agency for Health Care Administration finds and concludes as follows:

1. The Agency issued the attached Administrative Complaints, Notice of Intent to Deny Renewal Application, and Election of Rights forms to the Provider. (Ex. 1). The parties have since entered into the attached Settlement Agreement, which is adopted and incorporated by reference into this Final Order. (Ex. 2).

   
   

2. The Provider's license renewal application and the Agency's Notice of Intent to Deny Renewal Application are withdrawn effective January 31, 2021, or upon the issuance of a provisional license to a change of ownership applicant, whichever occurs first. Should a change of ownership fail, the Provider's license shall be cancelled effective January 31, 2021, without any further agency action and the Provider shall be required to comply with the requirements of facility closure.

   
   

3. The Provider shall pay the Agency $6,000.00. If full payment has been made, the cancelled check acts as receipt of payment and no further payment is required. If full payment has not been made, payment is due within 30 days of the Final Order. Overdue amounts are subject to statutory interest and may be referred to collections. A check made payable to the "Agency for Health Care Administration" and containing the AHCA ten-digit case number should be sent to:

Central Intake Unit

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 61

Tallahassee, Florida 32308

ORDERED at Tallahassee, Florida, on this jJ_ day of_ ' 2020.

/

Molly McKinstry, Deputy Secretary Agency for Health Care Administration

2

NOTICE OF RIGHT TO JUDICIAL REVIEW

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.

CERTIFICATE OF SERVICE

I CERTIFY that a true and corre t gwy i2fJ:his Final erved on the below-named persons by the method designated on this of , 2020.

Richar .hh ruop, Ag ncy Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: (850) 412-3630

3

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

SlA TE OF Fl.ORHJA, AGENCY FOR

HHAL"ll{ CARE ADMl fSTRATION,

DOAH Ntl:

Petilioner. Agency Nos.

RICHLAND RETIREMEl\'T SFl\lC)R HOME. ]NC.

R spondent,

20-05{•:!

2019005(}87

20I 1010945

20190 [0949

2019010955

/

RJCHI-A D RETIREMENT SF:NIOR HOME, lNC.

Petitioner.

OOAHNo:

Agency Nos.

20-0562

2019015055

V,

STATE OF FLORTOA, AGENCY FOR

HEAU'H CARE ADMINlSTRA TJON.

R pondent.

"!

STATE OF FLORJDA. AGENCY FOR

HEAT.TH CARE ADMINJSTRATION.

Petiliontr,

DOAHNo:

Agency N4,)S.

20-0562

2020012li0

v.

RICHLA D Rl::TIRD,1E1':T SENIOR HOME, lNC.•

Respondent.

Pagclof8

EXHIBIT 2

STATE Of FLORIDA, AGE CY FOR HP.AL.TH CARE ADMINISTRATION,

Peritioner. Agency Nos. 2019017715

V.

RICHLAND RETIRE.MEN'!' SENIOR HOME. INC.,

Respondent.

I

SETTLEMENT AGREEMENT

The State of Florida, Agency for Health Care Administration (herciriatler the •·Agency"). through its undersigned representatives, and Richland Retirement Senior Home, (nc. (hereinaJ\er "Richland''), pursuant t,, Section 120.57(4), Florida Statutes. each individually, a "purty."

collecti'1·ely as 1'pan ics." hereby enter into this Sett1cmenl Agreement ("A!!rccmcnt") aud agree

as fo1low1;:

WHEREAS, Richland was ataU times relevant an assisted living facility lkensed pursuant to Chapters 429, !>art l, and 408. Part 11, Florida Stat.ules, Section 20.42, Florida Stamtes and Chapter 59A-J6, f lorida Adminislrative Code; and

WHEREAS. the Agency ha.-.jurisdiction by virtue of being the regulatory and licensing

authority over Richland, punuant to Chapters 429, Part r, and 408. Part II. Florida Statutes and

\VHE-REAS, the Agency issued an Admini!ltrc1tive:: Complaint on October 25, 2019, ArlCA Case Nwnbcrs 20 l9005087, 2019010945, 2019010949, and 2019010955 seeking three thousand five hundn:d doJlars (SJ,500.00); and

WHEREAS, the Agency issued an Adminis1rdtive Complaint on January 9, 2020, AHCA C Number 20190 l 7715 seeking $1,000.00 in admini5trativc fines; and

Pagel of8

\\"IIERF.AS. the Agt:nr.:y issued an Arm..'>ftded Nmicc of Intenl to m.•ny the- Rcn.:-wal Application for An Assi ted living. thcrcinaJter "'.'IOID") AHCA Case Number 2019015055 l't)r the Rkhland·!-l facility c.m March 5. 2020.

WUif.REAS. th,; Agency completed a surv y of the Richland and it facility on July 7. 2020 tlu:reinaftcr ..Survey A"). :AIICA case number 2020012170. dl1ting which <lelicii:nt prac1icfs were cited; m1d

WHEREAS. the c:itati<m of the above reforcnccd deficient practice in Su:rvty A subjects

Rid11am.l LO Lhe imposition of adrninislmtivt sanctjons of on thou,ami five: hundrc.:d doll,-11·

{_SI ,S00.00}: and

WHERF.AS, the Parties have agreed to an amicable resolution of these case- .

0'\\' THli:JI.EFORE. for good and valuable conside,atiun. the sufficiency of which is hereby agrc d to and Ct)nfinned. the RichJand and the A£cncy agr c m; follows:

1. All of the abl)\.-c ri;dlals cm.: true and currei:1 and arc expressly incorporated inh1

   
   

   the Agrccincnt.

   
   

2. lhc Partic .tgm.: that the abov recitals arc binding findini;s of the Parties.

;\, Cpon full executhHl of this Agrcc-rmmt, tbe Richhind agrees to v1t·aivc nny and all app el::: and prn.;c din.1&s lo \-i;hich Lhey may he cntitlod, including but nul limited to. an mfonnal proccc-ding under St1hsectinn 120.57(2). Florida Statutes. a formal procc..-ctling uru.lcr Suh:si.:dion 120.57( I). FloriJu Statute . appeals undct· Section 120.68, Florida Stalutcs: and declaratory und

all writs of relief in any court or quasi•court of compclcnl juristliclion: and agrees Lo wui\l!

compliance with the form of tht Final Order (findings of fact and cortdusi,ms of h.tw} to whidt they may be entitled, provid d. however. that no agruermml herein shall be {lee1neJ a wai\'er hy an - pu.rty of its right Lo jvJ.i1.:iul cnfo,(Xmtnl uf this Agreement or the J\gcncy·s ri,1.d1ts under

1 The t111dinp. nf tht- sur"r"cy \!.·ere rcJ11i:l.'tl Ula slate fonn :1020.

Sc tion 120.6'· . Florida Statut (2019). Richland s1"JCCifo.:ally waives the ni:ccssity of th!! drafting <)f or service of un Administrative C:ornpla.int fiJr the relief ,;tipulutcd to in 1hi:s Agri= ni nt ai;. rhc same rehLLe.s lo the Survey A (hereinafter --survey").

1. Cpon full C:"<ecution of the Ag1·ccmcnt:

   
   

   a, Richland shall pay administrative tines in the amount of six thousand dollan, t$6.000.UO). Rfrhlwid shall puy the Agency the sum of S<J.f)00,00 bc1i.)rc 1hc lir:::.l oecunfog of: issuance of change of ownership liccnsurc to a third-pi,rty applicant or by Jttnuary :l 1. 021.

   b. The failure of the Richland to timely remit the administrative fines pur!-uant to thl· provisit",ns (11" :sub-p,migraph (4)(a) abm·c shall conslitute grounds for the de11inl or any third•par1y application for change of owm:rship lici:nsurc.

   . Richlnnd withdraw:. it!t application for renewal urliccm:1ure. assisted living ladlity lk(nse number 9475, crlcctivc .Tanu,1ry 31, 202 t, unless change of ownership lic nsure has b.:en granted to a third-party applicant pr1or thereto.

   1. All residents in Richland's a-;sisted living facility. licmsc numh..:ir 9475, shall he discharged on or 1iefore Janu ry 31, 202 l unless chan c or ownership liccm;ure ha!- hecn g.rnntcd h, a thi1·d-ptlrt)' apphcnnt pr1or thereto.

   2. Richland shall comply with all provisions ur Chapter 408, Pt.rt 11. n )rida Starnlc::.. Chaplcr 4'.::9. l>art L Florida Statutes. and Chapters 5Q:'\-35 t}tll1 5':)i\-36. rlorida Admini!-:trativc Code throughout 1hl:! discontimmtion of opcmtions inclut.1.ing, buL n<.1\ limil u 10, compliance with provi i,ms rehuerJ tu the tin,dy

      provishu, 1lf statutory or contractual notice of discharge 10 n.. idcnl ; the timely

      <listribulion or client records: and the timely provision of refunds 1.0 resid nts and

      th.-:! r lllm nf •· :;.id.:nt pcr.!>(.)lltll property. othin!! in lhi:; J\gr cnu.mt c1.\llp;; i,r

      
      

      
      

      prevents the Agency from seeking sanctinm; against the RichlanJ for .my non­ cmnpliancc \-vhich Richland may he cited l,,r huS<.-d upon the ucts ur omi!>:-;ion of Richlan1.i including. but not limited to, np ff"opriutc dischu.-gc. timely rcsid nt

      refund;;;, and the lim ly return of resident properly: and

      
      

      l'. Ft'fo tivt Jnnuary .31. 2021. nr 1.hc issuance of change nl' tw,mership licensur.:.

      
      

      whiL:h ver may occur first. th OID i deemed dc1ticd as moot.

      
      

   3. Effcclive January 31. 2021. or the issuance of the provisional license to a thil'd party change of ownership applicant. whichr:ver shall first occur. Richland shall he dive1;tcd of any right, title, or ml\.nership inlerest in license rtun,ber 9475.

2. Vcnul· for any action brought to enforce the krms ul'this Ag1·ccmcnt 01· chc Final

   
   

   OrJcr mered pursuant hereto all lie in Circuit C'ourt in Leon County. floritla.

   
   

3. By c>.ccuting this Agrcem1:nt. Ricllland denies. and the Agency ,m;ser1s the validity of thi.· alkgatiom; raised in the Admjnistrativc Complaints, }\()If) und Suf\/C}' rctcrcnccd h rdn. '\o a n.:cmcnt me.Kie her in shall preclude the Aicncy from imposing a penalty against

   .llichlar\d for any tfoliciency/violation of statute or ruk identified in a future survey of Richlanti.

   
   

   which constitutes a '·repeat'' or "'lUtcnrrected" deficiency fron\ surveys idenlilie<l in Lhe­ udrninistrath-'r complaint. ht aiJ vent, Richland 1 lains lhe right to challenge the factual allcgatklns rdawd w thl· Jelici nt praclicc11/violations alleged in the instant cuu c:.

4. .Ko t'l.gtccmcnt rr1mk herein shall prcclutl the Agency from using the deficiencies

   
   

   from the survl'ys identified in the m.lministmtive complainl in any decision regarding lkcnsurc l,f

   
   

   Ri!.!hla11d. including. hut not limile<l lo. licensure for limited mental health, limit d nurnini;

   
   

   :-; nic s. exlt!nJt!d congregalt: care. oi· a demonstrated pattcm of deficient performance. Tbc- 1\gcncy is not precluded from usin!!, the su iect events for ,1ny purpose within the jmisdiction of Lhe A ency. f urt.h r. Richland acknowledges and agrees that this /\gl'l-cmcnt shall not prccluJc

   
   

   or eshlp any other fcdcml, state, or loca.l agency or uffi.cc from pursuing any cause orauicm or laking tmy :ice ion. even if based on or arising from. in wholt: or in pa11, the fact raised in the administrotivc comp1aims. :'.\OH), w•cl survey. 'Jl1is agrccmcnl <locs not prohibil the Agem:y

   from ta.kin!!- action rcga1'i..1ing the Richhmd's Mt.>dicliid provi<ler statui:;, conr.lilions. requirements

   
   

   or wntral·t.

   
   

5. t pon full execution t)fthis Agreement. the Agency shall enter a Final OrJ r adilpting and incot')'lorating the terms of this Agreement and closing the above-styled case.

6. uch )arty hiill b1.:iir its nwn costs antl atlomcy'is li.:C8.

l U. 'Ibis. Agreement shall bccomt: ctfoctivc on the date upon which it is fully xccutcd by all tht parties.

1. Richland for 1ts •·elated or resulting orgm,i7.ations. its successors or mmsfcrccs,

   
   

   l-lttomcys. heirs. and cxrcutors 01· admjnistrators. docs hereby dischargi: the State of 1-'lorida, Agency for Health Can: Atlrnini:s rulion. am.l il agems. n:prt:s nta.th·!!s. and attorneys 01'"11J from all clliilm. demands. actions. causes of action. suits. damages. lo i:;es. and expensei::. of any and every nmure whatsoever, mising out ()for in any ·way related to this mallet' and the Agency's actions, including.. bl1t rmt limh-..-cl t..l, any claims that were ur may be asirurtcd in ,my l <.li:ntl or stall' court or adrr,inistrativl! fotunl. includir\g any clw llrising out uf it,i ugrccmcnt, hy tir t>n

   behalf of Richland or t"clatcd focili(ics.

   
   

2. Thi Agreement is binding upun aH parties herein and thos itlenlilied in

   
   

   J')aragraph eleven {l l ) of this Agreement.

   
   

3. In the ovcnt that Richland was a Medicaid provickr at the l-lu ject tirnc of th Oi;turn.'nccs alleged in the complaint herein. this settlement docs nl)t prevent the Agency thm1 seeking \fodicuid o,crpaymcnts related to the su jcct issues or from impo.si,1g any sanctions purowmt to Ruk 59G 9,07i.\ Florida Administrtitivc Code.

   
   

4. Richland agrc s that if any fonds to he paid under this agreement to th Ageni:- .- are nlH paid hy lhc date lhc CH OW appl kation is al)provt>d or b)' January .1 I. '.!021. wl,ic.:hcv .- may occur S<>tln r. the Agency may deduct the amounts assei;s d ag11i11st Richland, or any portion thereoJ: owed by Richland w 1he Agency from any present or fi.J.ture funds nw tl to Richland hy the Ag ncy, nnd that the Agency shall hold a lien against p1·cscnt and futul'C fonds o\\ell tn Richland by th(' Agency for said amounts until paid.

5. The undersigned have read and understand this Agreerncnt and have 1b( a1,,1ihorit)"

   
   

   to hind their respective principal!- to it. Richland has the capacity to execute this Agreemer1t.

   
   

6. This Agreement i.":ontains and it)Corporatcs the entire w t.lcrstanJings and agrt:'\!mcnts n 1· Lhc parties.

l 7. This AgrccmcnL sup!!r!!Cdes any prior oral or wTitlen agretments between th\.·

parties.

1. This Agreement may 1101 be amended except in w1·iting. Any attempted a:,;signrncnt of tbis Agrcl'.rm.:nt shall oc void.

2. All panies agri:e that a lacsimilt signature suflices for an original signaLun:.

O. The following. rcprc ntativcs hereby acknowledge that they arc duly m.rtlK•ri1.ed

to enter into tbis Agree11, nl.

r-.-1 •I ly c.·KKl'lt.r.;v, Dtpul)· Secrelary

1It: wi:'lity Asliunuwc

Agency fbr Hfalth Care Adminb1ration

'.2727 \1alum Dri..,.c. Building #I

Tal bhassee. flf>ridil 32J 08

Rickey Strong, Esq.

Counsel for Richland Retirement Senior

I lome. Im;.

Jeffrey S. llowcH. P.A.

2898-6 Mahan Drive

Tallahassee. Florida 32308

Rick(ajjsh-pa. l)Jn

H--Jv-

William Ko rtc;, Oencral CoL111sd

Office or tht Genercd C'oLJnscl

/\.g ncy for Health Care Administration 2727 -fahan Drive. 1S #3

"lallahasscc, rl-.,rid"' 32308 fl )ridu 'Rar l\o, 586617

/. / Dian,!, ,!i,f. Giraldo, F..'i£J.

Uiana M. {iiraldo, Senior Auonu:y

0 ffict" nf the Geneml Counscl

Agency for Health Cu.re ,\dministmtion

525 \1irr0l' Lakt Drive Korth. Suite .BOE

81. Peu rshurg, Florida 33701

Florida Bar 'l\'o. 11.1191

CZ

c: Pr eJ1d"""<."... t' ­

Richland Rctiren-.ent Senior I lomc, Inc.

--'T-- \[ - t'<l.'""le:lr::• [.\,

Richland tlir mem Senior I Jome. Inc.

DATED: Sept mhcr 17. 0:'.!0

Docket for Case No: 20-001082

Orders for Case No: 20-001082