~.. STATE OF FLORIDA PR AGENCY FOR HEALTH-CARE ADMINISTRATION (j CONS@LIDATED GROUP OF TAMPA, INC., d/b/a YBOR CITY HEALTHCARE AND REHABILITATION Petitionér, vs. . CASE NO.: 00-4557 ALS PROVIDER NO.: 212164 STATE OF FLORIDA, AGENCY AUDIT NO.: NioocoeaM FOR HEALTH CARE - ADMINISTRATION, RENDITION NO.: AHCA-O1- ti 5-S-MDA Respondent. / FINAL ORDER This cause came before me for the purpose of issuing a final agency order, it appearing from the Settlement Agreement, attached and incorporated herein, that there are no remaining disputed issues of fact. . FINDINGS OF FACT 1 ) On February 5, 2001, a Settlement Agreement between the parties was executed which dismissed the Petitioners case against the Agency. . 2. There are no remaining disputed issues of fact or law. . CONCLUSIONS OF LAW The Agency has jurisdiction over the parties and subject matter pursuant to Section 120. 57 , Fla. Stat. (2000), The parties are directed to comply with the terms of the Stipulation, Settlement and Dismissal. The petition is dismissed and the file is closed this ys BY day ot lary, 2001. Secretary Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK, 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 THE RENDITION OF THE ORDER TO BE REVIEWED. Copies Furnished to: Lawrence P. Stevenson Mary Stewart, CPA Administrative Law Judge Manager, Audit Services DOAH ' AHCA, Bldg. #3 1230 Apalachee Parkway 2727 Mahan Drive - Tallahassee, FL 32399-3060 Tallahassee, FL 32308 Steven Grigas, Esquire _ AHCA, Bldg. #3 2727 Mahan Drive Tallahassee, FL 32308 Michael Bittman, Esquire . Gray Harris Robinson, P.A. PO Box 3068 Orlando, FL 32802 ” CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been ee furnished to the above named addressees by U.S. Mail on this the / Kay of E of Eebroaty, “t 2001. . Power, Esquire Agency Clerk State of Florida rod .. STATE OF FLORIDA | DIVISION OF ADMINISTRATIVE HEARINGS CONSOLIDATED GROUP OF TAMPA, INC., d/b/a YBOR CITY HEALTHCARE AND REHABILITATION CENTER, Petitioner, vs. DOAH CASE NO. 00-4557 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / STIPULATION AND SETTLEMENT AGREEMENT This stipulation and settlement agreement is entered into by and between the Agency for Health Care Administration (“Agency”), and Consolidated Group of Tampa, Inc., d/b/a Ybor City Healthcare and Rehabilitation Center (“Ybor City”). WHEREAS, Ybor City filed a petition with the Division of Administrative Hearings (DOAH) challenging the Agency's audit of its Medicaid cost reports for the periods ending August 31, 1896, and August 31, 1997; and WHEREAS, the parties entered into settlement negotiations and as a result of those negotiations, the undersigned parties now desire to resolve this proceeding without the necessity of future litigation and expense; and % x WHEREAS, the parties agree that upon execution of this stipulation and settlement agreement, this proceeding will be voluntarily dismissed with prejudice. NOW THEREFORE, in consideration of the mutual covenants contained herein, the sufficiency of which is acknowledged by all parties, it is hereby stipulated and agreed by and between the parties as follows: 1. This agreement resolves all issues in this proceeding and is based in parton the letter dated November 21, 2000, from William S. Musheno, AHCA Audit Evaluation and Review Analyst, to Ybor City, which is incorporated herein by reference as Exhibit A. The parties agree to the disposition of certain audit adiustments to the Ybor City Medicaid audit reports for the cost reporting periods ended August 31, 1996, and August 31, 1997, and the Agency agrees to make the following changes to the audit reports: Year Ended August 31, 1996 . a Adjustment 4 on page 8 of the audit report to administrative salaries - other in the amount of $27,189 wil be removed. b. Adjustment 6 on page 8 of the audit report to management services in the amount of ($27,189) will be removed. Year Ended August 31, 1997 Cc. Adjustment 4 on page 8 of the audit report to ~ ‘management services in the amount of $63,122 will be removed. x oo le d. Adjustment, 8. on page 9 of the audit report to - management services in the amount of ($63,122) will be removed. 2. The parties agree that the changes referenced in this agreement are the only changes to be made to the Ybor City audit reports for the cost reporting periods ended August 31, 1996, and August 31, 1997, other than adjustments affecting ending equity capital, if any, resulting from the revisions in paragraph 1 above. 3. The Agency agrees to revise the Ybor City audit reports forthe periods ended August 31, 1996, and August 31, 1997, to reflect the above changes and will mail to Ybor City the revised audit reports within a reasonable period of time after the issuance of the final order incorporating this agreement. The Agency will also revise Ybor City's Medicaid reimbursement rate(s) in accordance with this agreement. 4. The parties agree that no modification or waiver of any term of this agreement shall be valid unless made in writing, and signed by both parties. No waiver of any breach or default hereunder shall be deemed a waiver of any subsequent breach or default. 5. The signatories hereto represent and warrant that they are vested with the authority to execute this stipulation and settlement agreement on behalf of their respective principals and as duly designated representatives, to fully bind such principals, their 4 successors and assigns. 6. Each party shall bear. its own attorney's fees and costs. The allowability of Ybor City’s attomey’s fees and costs in ‘subsequent cost reporting periods shall be ee governed by the Florida Title XIX Long-Term Care Reimbursement Plan. THE PETITIONER, CONSOLIDATED GROUP OF TAMPA, INC., d/b/a YBOR CITY HEALTHCARE - AND REHABILITATION CENTER By: Guy Farmer resident Its: th Dated: December / of , 2000 Florida Bar No. 0347132 Gray, Harris & Robinson, P.A. 301 E. Pine Street, Suite 1400 Post Office Box 3068 Orlando, FL 32802-3068 (407) 843-8880 Telephone (407) 244-5690 Facsimile Attorneys for Petitioner Dated: December . ik , 2000 THE RESPONDENT, AGENCY FOR HEALTH CARE ADMINISTRATION By: (00 Yalu u— Bob Sharpe Its:__ Acting Director of Medicaid stl ENA. GRIGAS Florida Bar No. 0981818 Senior Attorney Agency for Health Care Administration 2727 Mahan Drive Fort Knox Ill, Suite 3431 Tallahassee, FL 32308-5403 (850) 921-0056 Telephone (850) 413-9313 Facsimile Dated: A-S-O/f GALLAGHER General Counsel Agency for Health Care Administration - 2727 Mahan Drive 5 Fort Knox III Tallahassee, FL 32308 (850) 922-5873 Telephone Dated: hls FROM = * 2727 Maken Deive Mail Stop 21 NOW. 21, 20e 2:gled ov 2 : Nov 21 100” errno PEER AHCAVPROGRAM ANALYSIS Fax: et AGENCY FOR HEALTH GARE ADMINISTRATION MITCHELL 2 £0. CPA's PHONE NO. : 8S 386 6955 ii: 48 Pp November 21, 2000 . CERTIFIED MAIL RETURN RECEIPT No. Z083 098 500 Ybor City Healthcare & Rehab Cir 1709 Talliaferro Avenue Tampa, Florida 33602 Re: Florida Medicaid Audit Appeal for Cost Reports Case'No. 00-4557 Ybor City Healthcare & Rehab Ctr 8/31/96 NH99-| Ybor City Healthcare & Rehab Ctr 8/31/97 NH99- Dear Administrator: Upon further review of the reclassification of quality assurance manag to my telephone conversation with Guy Farmer and Beverly Mitchell on following changes will be made in exchange for dismissal with prejudi appeals. Yor City Healthcare & Rehab Ctr Period End 8/31/06 Schedule of Adjustments - Adjustments affecting costs page 8, numb $27,189 reclassification of cost will be removed. Schedule of Adjustments — - Adjustments affecting costs page 8, numb $(27, 189) reclassification of cost will be removed. eal} ; 8/31/9 6AM | t fees and in response vember 21, 2000, the of the related audit a . 4 (Audit ATE#S) - 6 (Audit ATBHS) - Schedule of Adjustments — Adjustments affecting costs ' page 8; number 4 Cua AIE#10) - $63, 122 reclassification of cost will be removed. Schedule of Adjustments — Adjustments affecting costs page 9, number 8 Gud ANB#IO) - $(63, 122) reclassification of cost will be removed. -Tallstaeses, FL 3230 ae EXHIBIT A HOU-21-2888 14:42 : 850 386 6955 95% x OTT Visit AHCA Online at -- P.@2 FROM : MITCHELL 2 CO, CPA's CHONE HO. ot 659 386 S286 _ PHCA/PROGRAM ANALYSIS Fax:850-414-9789 v21 ‘00 saa P02 No arte ‘Ybor City Healthcare & Rehab Ctr. November 21, 2000 ~~ Page 2 - The terms of this letter are for settlement purposes only, The assertions be considered admissiona on the part of the agency. This letter should| not be considered a . settlement document unless incorporated into a settlement document. The above audit reports will be revised and reissued to reflect appropriate] changes necessitated -by this agreement. Doe If these changes are in accord with your understanding, please forward this letter tb Consolidated Group of Tampa, Inc.’s legal counsel for drafting of a settlement stipulation. You assistance in * bringing this matter to a close is appreciated. “ ; : If you have any questions concerning this letter, please call mo at (850) 414.2774. ‘Sincerely, La Ja 4 ‘ William S$, Musheno, Audit Evaluation and Review Analyst /WSM. : co: Via Facsimile (850) 386-6955 C. Guy Farmer Mitchell & Company , CPA’s . 2851 Remington Green Circle, Suite D Tallahassee, Florida 32308 Mary Stewart, Administrator of Audit Services, AHICA Steve Grigas, Senior Attorney, AHCA NOU-S1-2809 1ah42 0 sae se Bass ees ‘94x “Bigg aw

Docket for Case No: 00-004557