STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

IDA BELLE HILL RETIREMENT HOME, )

)

Petitioner, )

)

v. ) CASE NO. 86-0921

)

DEPARTMENT OF HEALTH AND )

REHABILITATIVE SERVICES, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its duly designated hearing officer, James E. Bradwell, held a public hearing in this case on May 1, 1986, in Hollywood, Florida. Pursuant to leave, the parties were afforded to August 20, 1986, to submit Proposed Recommended Orders supportive of their respective positions. Respondent's counsel has submitted a Proposed Recommended Order which was considered by me in preparation of this Recommended Order.

APPEARANCES

For Petitioner: James A. Pearson, Esquire

Pearson & Silver Attorneys at Law

2435 Hollywood Boulevard, Suite 205

Hollywood, Florida 33020

For Respondent: Carol L. Braynon, Esquire

District Legal Counsel Department of Health and Rehabilitative Services

201 West Broward Boulevard Ft. Lauderdale, Florida 33301

Dennis E. Berger, Esquire

Office of Licensure and Certification Department of Health and

Rehabilitative Services 5190 Northwest 167th Street Miami, Florida 33014

ISSUES PRESENTED

The issues presented for decision herein are whether or not Petitioner's application for re-licensure as an Adult Congregate Living Facilities (ACLF), should be approved.

FINDINGS OF FACT

1. Based upon my observation of the witnesses and their demeanor while testifying, documentary evidence received and the entire record compiled herein, I hereby make the following relevant factual findings.

   
   

2. Ida Belle Hill Retirement Home and Ida Belle Hill Boarding Home are adult congregate living facilities (ACLF), located at 5218 and 5512 Mayo Street, Hollywood, Florida. Adult facilities are licensed by Respondent. The licenses on both facilities expired November 19, 1985, and by letter dated November 25, 1985, the applications for re-licensure were denied.

   
   

3. Annual surveys were made of the facilities by Respondent's inspector for the Office of Licensure and Certification, Phillip Drabick. Drabick's first inspection of the facilities was on July 29, 1985, with a follow-up visit on November 5, 1985.

   
   

4. The parties stipulated that Petitioner's application for re-licensure as an ACLF was timely made and accepted by the Respondent and that a primie facie case had been established by Petitioner as relates to the application for re-licensure. (TR 12). Based on that stipulation, Respondent has an aversion of proving that Petitioner is not entitled to re-licensure as an ACLF. The parties stipulated that both cases should be consolidated for hearing.

   
   

5. Petitioner stipulated that the conditions and deficiencies noted by Respondent, Office of Licensure and Certification, on March 5, 1985, were extant and did exist at that time. (TR 54).

   
   

6. Petitioner was made aware of all deficiencies at the times they were observed by Respondent.

   
   

7. During those inspections, the following conditions were found and brought to Respondent's attention on both facilities as follows:

   
   

8. The facility owner, Ida Belle Hill, served as representative payee and has not filed a surety bond with the Department (HRS) in an amount equal to twice the average monthly aggregate income of personal funds due residents. (TR 61-63, 75).

   
   

9. The facility does not keep complete and accurate records of personal funds of residents. (TR 63, 64, 75 and 77).

   
   

10. The facility does not maintain a current admissions and discharge record of all residents, including temporary emergency placement. (TR 35, 37 and 60).

    
    

11. Up to date the other records that were not kept on file for residents who received supervision of self-administered medications. (TR 64, 65 and 78).

    
    

12. Services delivered by third party contractors, such as doctors, dentists and other health care professionals are not documented and placed in each resident's medical records. (TR 65, 78).

    
    

13. The facility does not maintain a record of personnel policies including employment policies and work assignments for each position. (TR 63- 66, 67 and 78).

14. The facility does not maintain a written work schedule for employees including provision for relief staff and coverage for vacations, sick leave and other emergencies. (TR 66, 78).

    
    

15. The facility does not maintain time sheets for employees. (TR 67,

    79).

    
    

16. The facility does not have one staff member within the facility at all

    times who has certification in an approved first aid course. (TR 66, 67, 68, 79 and 80).

    
    

17. The facility does not have job descriptions for staff who are responsible for providing personal care to residents. (TR 69, 80).

    
    

18. The facility does not maintain the required medical form for residents admitted from other state institutions such as South Florida State Hospital.

    (TR 69, 80).

    
    

19. The facilities house residents that have not been examined by a licensed physician or licensed nurse practitioner within sixty days before admission or within thirty days following admissions. Additionally, the facility does not maintain a completed, signed health assessment for ACLF facilities and the resident's files for each resident. (TR 60, 61, 80 and 81).

    
    

20. The facility does not maintain written policies, procedures for assisting residents in making appointments to appropriate medical, dental, nursing or mental health services as is necessary for the care of its residents and for providing all transportation to and from the centers which provide the provision of the required services. (TR 69, 70, 80 and 81).

    
    

    THE FOLLOWING DEFICIENCIES WERE FOUND TO EXIST AND WERE BROUGHT TO PETITIONER'S ATTENTION AS RELATES TO IDA BELLE HILL BOARDING HOME.

    
    

21. The facility does not have food service policies and procedures for providing proper nutritional care for residents whether provided by the facility or a third party. (TR 70).

    
    

22. Dietary allowances are not met by offering a variety of foods adapted to food habits, preference and physical abilities of residents and prepared by the use of standardized recipes. (TR 70, 71).

    
    

23. The facility does not maintain an up to date diet manual, approved by HRS, to use as a standard reference in planning regular and therapeutic diets. (TR 71).

    
    

24. Menus are not corrected as served and maintained on file for the required six months. (TR 71, 72).

    
    

25. The facility does not maintain, at the premises, a one week supply of non-perishable food based on the number of weekly meals that the facility has contracted to serve. (TR 72).

    
    

    CONCLUSIONS OF LAW

    
    

26. The Division of Administrative Hearings has jurisdiction over the subject matter and the parties to this action. Section 120.57(1), Florida Statutes.

27. The parties were duly noticed pursuant to the notice provisions of Chapter 120, Florida Statutes.

    
    

28. The authority of the Respondent, Department of Health and Rehabilitative Services, Office of Licensure and Certification, is derived from Chapter 400, Florida Statutes.

    
    

29. Petitioner is required to be licensed to operate an adult congregate living facility. (Sections 400.402(2), 400.404(1) and 400.407(1)(a), Florida Statutes.

1. The Department of Health and Rehabilitative Services, Office of Licensure and Certification, may deny a license on the basis of " intentional

   or negligent acts seriously affecting the health, safety or welfare of a ...

   resident(s) of [a] facility." Section 400.414(1) and (2), Florida Statutes.

   
   

2. Upon application for renewal of licensure, a license shall be renewed by the Department if the applicant has first met the requirements of Chapter 400, part 2, Florida Statutes, and all rules and regulations promulgated thereunder. Section 400.417(1), Florida Statutes.

   
   

3. Petitioner, having failed to file a surety bond with the Department in an amount equal to twice the average monthly aggregate income of personal funds due residents engaged in conduct violative of rule 10A-5.14(4)(b)(2)(a), Florida Administrative Code.

   
   

4. Petitioner having failed to keep complete and accurate records for personal funds held for residents engaged in conduct violative of Chapter 400.427(4), Florida Statutes.

   
   

5. Petitioner, having failed to maintain current admissions and discharge resident's records, including temporary emergency service placement, engaged in conduct violative of Rule 10A-5.24(1)(a)(b), Florida Administrative Code.

   
   

6. Petitioner, having failed to maintain daily records for residents who receive supervision of self-administered medications, engaged in conduct violative of Rule Section 10A 5.24(1)(a) 3, Florida Administrative Code.

   
   

7. Petitioner, having failed to document and place in each resident's medical records services delivered by third party contractors engaged in conduct violative of Rule 10A-5.24(1)(a)3, Florida Administrative Code.

   
   

8. Petitioner, by failing to maintain a record of personnel policies including policies and work assignments for each employee, engaged in conduct violative of Rule 10A 5.24(1)(a)5, Florida Administrative Code.

   
   

9. Petitioner, by failing to maintain written work schedules for its employees including provisions for relief staff and coverage for vacation, sick leave and other emergencies, engaged in conduct violative of Rule Section 10A- 5.24(1)(a)6, Florida Administrative Code.

   
   

10. Petitioner, by failing to maintain time sheets for its employees engaged in conduct violative of Rule Section 10A 5.24(1)(a)7, Florida Administrative Code.

11. Petitioner, by failing to maintain on staff, one employee within the facility at all times who has an approved certified first aid course, engaged in conduct violative of Rule Section 10A-5.19(5)(f), Florida Administrative Code.

    
    

12. Petitioner, by failing to maintain a list of its staff, job descriptions, who are responsible for providing personal care to residents, engaged in conduct violative of Rule Section 10A 5.19(5)(d), Florida Administrative Code.

    
    

13. Petitioner, by failing to maintain the required medical form for residents admitted from other state institutions, engaged in conduct violative of Rule Section 10A-5.18(1)(b), Florida Administrative Code.

    
    

14. Petitioner, by failing to insure that its residents have been examined by a licensed physician or licensed nurse practitioner as required before admission to the facility or within thirty days following admission and by failing to maintain completed, signed health assessments for its residents, engaged in conduct violative of Chapter 400.426(3),(4), and (i), Florida Statutes and Rule Section 10A-5.181(1)(a), Florida Administrative Code.

    
    

15. Petitioner, by failing to maintain written policies and procedures for fifty residents, making appointments to appropriate medical, dental, nursing or other mental health services as required and by providing the requisite transportation to and from the required services, engaged in conduct violative of Rule Section 10A-5.182(8) and (9), Florida Administrative Code.

1/ 44. Petitioner, by failing to maintain the food service policies and procedures for providing proper nutritional care for residents engaged in conduct violative of Rule Section 10A 5.24(1)(d)1a and 10A-5.20, Florida Administrative Code.

1. Petitioner, by failing to offer a variety of food adapted to the food habits, preference and physical abilities of residents, and prepared by the use of standardized recipes, engaged in conduct violative of Rule Section 10A- 5.20(1)(g), Florida Administrative Code.

   
   

2. Petitioner, by failing to maintain up to date diet manuals, approved by the Department to use as a standard reference in planning regular and therapeutic diets, engaged in conduct violative of Rule Section 10A-5.1(i), Florida Administrative Code.

   
   

3. Petitioner, by failing to make menus as served, and kept on file for examination for the required six month period following serving, engaged in conduct violative of Rule Section 10A-5.20(1)(j), Florida Administrative Code.

   
   

4. Petitioner, by failing to maintain at the facility a one week supply of non-perishable food based on the number of weekly meals at the facility contracted to serve, engaged in conduct violative of Rule Section 10A- 5.20(1)(k), Florida Administrative Code.

RECOMMENDATION

Based on the foregoing findings of fact and conclusions of law including the fact that the violations noted herein are numerous and continuing over an extended period of time, notwithstanding efforts by Respondent to gain compliance by Petitioner, finds that Respondent has not established compliance with Chapter 400, Part 2, Florida Statutes, respecting the entitlement to re- licensure as adult congregate living facilities. Based thereon, it is RECOMMENDED:

That a Final Order be entered herein by the Department of Health and Rehabilitative Services, Office of Licensure and Certification, denying Petitioner's application for re-licensure as an adult congregate living facilities for Ida Belle Hill Boarding Home and Ida Belle Retirement Home situated at 5512 and 5218 Mayo Street, Hollywood, Florida, 33021.

Recommended this 21st day of October, 1986, in Tallahassee, Florida.

JAMES E. BRADWELL

Hearing Officer

Division of Administrative Hearings The Oakland Building

2009 Apalachee Parkway

Tallahassee, Florida 32301

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this 21st day of October, 1986.

ENDNOTE

1/ The following conclusions of law relates to Petitioner's facility, Ida Belle Hill Board Home.

COPIES FURNISHED:

James A. Pearson, Esquire 2435 Hollywood Boulevard

Hollywood, Florida 33020

Dennis Berger, Esquire Office of Licensure and Certification

5190 NW 167th Street Miami, Florida 33014

Docket for Case No: 86-000921

Orders for Case No: 86-000921