STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

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CLERK

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

2021 MAR I 9 A 8: 5b

Petitioner,

V.

GVDB OPERATIONS, LLC d/b/a GRAND VILLA OF DELRAY EAST,

DOAH No. 20-5408

ACHA No. 2020010121

Facility Type: Assisted Living

RENDITION NO.: AHCA- Z I - Z-33 -S-OLC

Respondent.

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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 Complaint and Election of Rights form to the Respondent. (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 Respondent shall pay the Agency $1,000.00. 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

Ta llahassee , Florida 32308

ORDERED at Tallahassee, Florida, on this J.::1_ day of '2021.

c · nstry, Deputy Secretary

or ealth Care Administration

Filed March 31, 2021 1:53 PM Division of Administrative Hearings

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 correct y3f!his Final 0 served on the below-named

persons by the method designated on this £J"!

.,,>'(fay of

, . re..-< , 2021.

hi-,1--1,HTi'\oop, Agen

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

Telephone: (850) 412-3630

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STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

Petitioner,

1. DOAH No. 20-5408

   ACHA No. 2020010121

   GVDB OPERATIONS, LLC d/b/a GRAND VILLA OF DELRAY EAST,

   
   

   Respondent.

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   SETTLEMENT AGREEMENT

   
   

   Petitioner, State of Florida, Agency for Health Care Administration (hereinafter the "Agency"), through its undersigned representatives, and Respondent, GVDB Operations, LLC d/b/a Grand Villa of Delray East (hereinafter "Respondent"), 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, Respondent was at all times relevant an assisted living facility licensed pursuant to Chapters 429, Part I, and 408, Part II, Florida Statutes, Section 20.42, Florida Statutes and Chapter 59A-36, Florida Administrative Code; and

   WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over Respondent, pursuant to Chapters 429, Part I, and 408, Part II, Florida Statutes; and

   WHEREAS, the Agency served Respondent with an administrative complaint on or about December 7, 2020, notifying the Respondent of its intent to impose administrative fines in the amount of five thousand dollars ($5,000.00) plus a survey fee of five hundred dollars

   EXHIBIT 2

   ($500.00) for a total assessment of five thousand five hundred dollars ($5,500.00) based upon a Class II deficient practice cited by the Agency as "ID Prefix Tag A30" from a survey completed on May 19, 2020 (hereinafter "Survey"); and

   WHEREAS, the parties have negotiated 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 herein 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.

   3. Upon full execution of this Agreement, Respondent agrees to waive any and all appeals and proceedings to which it may be entitled related to this state proceeding including, but not limited to, an informal proceeding under Subsection 120.57(2), Florida Statutes, a formal proceeding under Subsection 120.57(1), Florida Statutes, appeals under Section 120.68, Florida Statutes; and declaratory and all writs of relief in any court or quasi-court of competent jurisdiction; and agrees to waive compliance with the form of the Final Order (findings of fact and conclusions oflaw) 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:

      
      

      1. The Administrative Complaint issued in this cause is deemed voluntarily dismissed.

      2. Respondent shall pay one thousand dollars ($1,000.00) in administrative sanctions based upon allegations of the failure to document staff training contained in the

         
         

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         Survey within thirty (30) days of the entry of the Final Orde and the deficiency is deemed a Class III deficient practice.

   5. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in Circuit Court in Leon County, Florida.

   6. No agreement made herein shall preclude the Agency from using the alleged deficiencies from the surveys identified in the administrative complaint in any decision regarding licensure of Respondent, including, but not limited to, a demonstrated pattern of deficient perfonnance. The Agency is not precluded from using the subject events for any purpose within the jurisdiction of the Agency. Further, Respondent acknowledges and agrees that this Agreement shall not preclude or estop any other federal, state, or local agency or office from pursuing any cause of action or taking any action, even if based on or arising from, in whole or in part, the alleged facts raised in the Survey. This agreement does not prohibit the Agency from taking action regarding Respondent's Medicaid provider status, conditions, requirements or contract.

   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. Respondent for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the State of Florida, Agency for Health Care Administration, and its agents, representatives, and attorneys of and from all claims, demands, actions, causes of action, suits, damages, losses, and expenses,

       
       

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       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 Respondent or related facilities.

   11. This Agreement is binding upon all parties herein and those identified in paragraph ten ( I 0) of this Agreement.

   12. In the event that Respondent was a Medicaid provider at the subject time of the alleged occurrences outlined in the complaint herein, this settlement does not prevent the Agency from seeking Medicaid overpayments related to the subject issues or from imposing any sanctions pursuant to Rule 590-9.070, Florida Administrative Code.

   13. Respondent agrees that if any funds to be paid under this agreement to the Agency

       
       

       are not paid within thirty-one (31) days of entry of the Final Order in this matter, the Agency may deduct the amounts assessed against Respondent in the Final Order, or any portion thereof, owed by Respondent to the Agency from any present or future funds owed to Respondent by the Agency, and that the Agency shall hold a lien against present and future funds owed to Respondent by the Agency for said amounts until paid.

   14. The undersigned have read and understand this Agreement and have the authority to bind their respective principals to it. Respondent has the capacity to execute this Agreement.

   15. This Agreement contains and incorporates the entire understandings and agreements of the parties.

   16. This Agreement supersedes any prior oral or written agreements between the

       
       

       parties.

       
       

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   17. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void.

   18. All parties agree that a facsimile signature suffices for an original signature.

The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement.

c try, Deputy Secretary

Hea uality Assurance

Agency for Health Care Administration

2727 Mahan Drive, Building #1

Tallahassee, Florida 32308

-- -···. . . - . - ,eJ

James arnado General Counsel

Agency for Health Care Administration 2727 Mahan Drive, MS #3

Tallahassee, Florida 32308

Amy •W. Schrader, Esq. Counsel for Respondent Baker, Donelson et al IO1 North Monroe Street Suite 925

Tallahassee, Florida 3230 I Florida Bar No. 621358

DATED: -+;6/S1

,Jc.NAr,1-p.,J S /1<::I;.J ,;. ,,1

Title: Ptzt!S

GVDB Operations, LLC d/b/a Grand Villa of Delray East

DATED: _z,-/1_2---,-)_z._!_

I t

Tho . Walsh II, Senior Attorney Offi e 0fthe General Counsel

Agency for Health Care Administration 525 Mirror Lake Drive North, Suite 3300 St. Petersburg, Flo "da 33701

Florida Bar ,o. 5 6365

DATED· 1/

5

Docket for Case No: 20-005408

Orders for Case No: 20-005408