eevee Wk esi ae STATE OF FLORIDA Nee 13 AGENCY FOR HEALTH CARE ADMINISTRATION “eES OI APR 4 fil c A fe ° VENCOR, INC., DEFARTMENT@RERK “fa. Petitioner, 4 We Ba" ah : ary Sg vs. - DOAH CASE NOs.: 00-4769 thru 00-479)1// oi Ys, yp We ; _ STATE OF FLORIDA, AGENCY Cc Lis Vip e FOR HEALTH CARE as fete ADMINISTRATION, ; Respondent. / o FINAL ORDER : This cause came before me for the purpose of issuing a final agency order, it appearing from the Stipulation and Settlement Agreement, attached and incorporated herein, that there are no remaining disputed issues of fact. This Final Order references the following cases and facilities: 00-4769 (Bay Pointe); 00-4770 (Boca Raton); 00- Seeger ror pert 477] (East Manor); 00-4772 (Lago Vista); 00-4773 (Menorah House); 00-4774 (Oaks at Avon); 00-4775 (Palm Beach). FINDINGS OF FACT 1. On I ECE oe & ID > 2001, a Stipulation and Settlement Agreement between the parties was executed which dismissed the Petitioners case against foe ce the Agency. one, 18, 2000 an Order Closing File was entered by the Division of Administrative Hearings, tetamning jurisdiction to the he Agency fo for fi nal 1 disposition. CORRE corer pee one 2. There are no o remaining disputed is issues 2s 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 [OD dayof Ne@eMbee _, 2001. Rhonda Pome, flip — 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: John Van Laningham Julia Lee Administrative Law Judge Finance and Accounting DOAH ' AHCA 1230 Apalachee Parkway 2727 Mahan Drive Tallahassee, FL 32399-3060 Tallahassee, FL 32308 Steven Grigas, Esquire ——— Lisa Milton AHCA, Bldg. #3 AHCA, Bldg. #3 2727 Mahan Drive 2727 Mahan Drive Tallahassee, FL 32308 Tallahassee, FL 32308 Al Clark, Esquire 117 S: Gadsden St., #201 Tallahassee, FL 32302 eee fe ae an ee CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by U.S. Mail on this the |"1_ day of Ri KEM Ee, 2001. } Seeeenereres ence = | up | « S oe Agency Clerk State of Florida 3 Some ga nee rape DIVISION OF eee OT DEC > HEARINGS 20 AM IO: 59 fio VENCOR, INC., Agency for Health Care Administration Petitioner, Case Nos. 00-4775 vs. 00-4769 AGENCY FOR HEALTH CARE 00-4770 ADMINISTRATION, 00-4771 00-4772 Respondent. 00-4773 00-4774 eS SS SS SSS a STIPULATION AND SETTLEMENT AGREEMENT Petitioner, VENCOR, INC., and Respondent, AGENCY FOR HEALTH CARE ADMINISTRATION, by and through undersigned counsel, stipulate and agree as follows for the purpose of full and complete settlement of the above-referenced Medicaid audit proceedings: 1. Respondent proposed and Petitioner challenged certain Medicaid audit adjustments relating to the following nursing home providers owned and operated by VENCOR, INC., now known as KINDRED HEALTHCARE, INC.: Rehab Center of the Palm Beaches, NH99-096M; Bay Pointe Nursing Pavillion, NH99-163M; Boca Raton Rehab Center, NH99-091M; Fast. Manor Medical Center, NH99-092M; Lago Vista Care Center, NH99-093M; Menorah House, NH99-094M; and The Oaks at Avon, NH99-095M. 2. Respondent and Petitioner have conferred and have examined various documents relating to the proposed audit adjustments. As a result of these negotiations and examinations, Petitioner and Respondent have determined that it is in their mutual best interests to settle this proceeding in accordance with the terms of this Stipulation and Settlement Agreement. 3. Upon full and complete execution of this Stipulation and Settlement Agreement, Petitioner shall dismiss with prejudice its Petition for Formal Administrative Proceedings and Respondent shall enter a Final Order adopting the terms of this Stipulation and Settlement Agreement. Petitioner shall be entitled to enforce this Stipulation and Settlement Agreement in accordance with the provisions of Chapter 120, Florida Statutes. 4. Upon full and complete execution of this Stipulation and Settlement Agreement, Respondent agrees to amend or revise the above-referenced Medicaid audit reports in accordance with the attached letter dated September 13, 2001, and within a reasonable period of time revise the Medicaid reimbursement rates for each facility in accordance with the revised Medicaid audit reports. 5. For the purpose of this proceeding, each party shall bear its own costs and fees. However, this paragraph shall not be construed to determine the allowability of fees and costs for the purpose of application of reimbursement principles in accordance with the Florida Long Term Care Reimbursement Plan. DATED this day of ; , 2001. ALFRED W. CLARK, Esquire 117 South Gadsden St., #201 Post Office Box 623 (32302) Tallahassee, Florida 32301 Telephone: 850/224-6161 Florida Bar No. 117914 sprrems == CORRE RP RETRY ER EER eR oRe Re REP eR = he TEVEN GR: S, Egguire AGENCY FOR HEAL CARE ADMINISTRATION 2727 Mahan Drive Tallahassee, FL 32308 Telephone: 850/921-0056 ’” WILLIAM ROBERTS Acting General Counsel AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive Tallahassee, FL 32308 Telephone: 850/921-0056 BOB SHARPE Deputy Secretary of Medicaid AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive Tallahassee, FL 32308 Sr ye ag oy ere rr SEP-14-01 FRI 02:16 PM KINDRED FAX NO, 9964108 P, 02 Mb Tee. “Wy 921 NORTH DAVIS STREET BLDG A*SUITE 158 JACKSONVILLE, FL 32209 September 13, 2001 Mr. S. David Simpson Kindred Healthcare 680 South Fourth Avenue Louisville, Kentucky 40202 Subject: Administrative Appeals: Boca Raton /! NH99-091M East Manor /} NHS9-092M Lago Vista /f NH99-093M Menorah House // NHS9-094M Oaks atAvon // NH99-095M Rehab-Palm Bch // NHS9-096M Bay Pointe ii NH99-163M Dear Mr. Simpson: Per review of the information submitted to date, following is a summary of the proposed revisions to the above facilities audit report. If you agree with the following, please initiate the preparation of the settlement agreement, Boca Raton 1} Page 3 of the audit report (Schedule of Charges) will be revised in accordance with the enclosed Appendix A. . 2) Adjustment no. 11 will be reduced by $55,119 to $(39,622); as a result of the revisions made to the Schedule of Home Office Adjustments. ; East Manor 3) Page 3 of the audit report (Schedule of Charges) will be revised in accordance with enclosed Appendix B. . 4) Adjustment no. 11 will be reduced by $43,629 to $(31 383); as per #2 above. STATE OF FLORIDA « AGENCY FOR HEALTE CARE ADMINISTRATICN “ MEDICAID PROGRAM ANALYSIS P.O. BOX 12500 + TALLAHASSEE, FLORIDA « 32317~2500 a JEB RUSE. RoawreNar Fee cor rwme orgy gene ger REET anal a eer SRI Sr ne > mre pe ree Tere SEP-14-01 FRI 02:17 PM KINDRED FAX NO. 6964108 Mr. Simpson September 13, 2001 Page 2 Lago Vista 5) Adjustment no. 12 will be reduced by $68,073 to $(48,933); as per # 2 above. Menorah House 6) Page 3 of the audit report (Schedule of Charges) will be revised in accordance with enclosed Appendix C. 7) Adjustment no. 6 will be reduced by $49,015 to $(35,234); as per # 2 above. Oaks at Avon 8) Page 3 of the audit report (Schedule of Charges) will be revised in accordance with enclosed Appendix D, 9) Adjustment no. 9 will be reduced by $26,841 to $(19,284); as per #2 above, 10) Adjustment no. 22 will be reduced by $254,631 to $(448,254), Rehab-Palm Beach 11) Adjustment no. 12 will be reduced by $54,148 to $(38,924): as per # 2 above. Bay Pointe 12) Page 3 of the audit report (Schedule of Charges) will be revised in accordance with enclosed Appendix E. Pee as 13) Adjustment no. 7 will be reduced by $45,824 to $(32,939): as per # 2 above. All Facilities (Schedule of Home of Adjustments ; 14) Home office adjustment #25 will be reduced by $1 8,665,494 to $(1 422,784). Sincerely, Gk C Wilden Errof C. Williams AHCA Medicaid Audit Services » 03 TET gE rep reese SRNR Ree ee gene re yO RPE FAX NO. 6964108 P, Od Aopndix A SEP-{4-01 FRI 02:18 PM KINDRED Boca Raton Rehabilitation Center Schedule of Charges For the year ended May! 31, 1997 Increase As Reported (Decrease) As Adjusted Usual and customary daily rate 3S 19462" $ : ‘3 4oa6a- ———SS ————— ——S——S Cir.or) (22.04 Patient charges: Medicaid: Ancillary cost centers: Physical therapy $ 14,860 $ 0 $ 14,860 Speech therapy 880 is} 680 Occupational therapy 10,040 0 10,040 Audiological therapy 0 0 0 Medical supplies 8,984 70 8,984 Other 14,486 2th Oe loin 44496 Room and board 3,556,538 (4.Sto)}} 3.851.126 ~3,856,536- Other fe] (e) 0 Totals 3,605,786 = ~3,808786- 3,603,402 Medicare: Ancillary cost centers: Physical therapy 4,295,960 QO 1,295,960 Speech therapy 466,800 0 466,800 Occupational therapy 1,347,800 0 1,347,800 Audiological therapy 0 a 0 ie} Medical supplies 13,483 13,453 Other: 797,263 (vats) a Ai Room and board 1,385,670 i C6 1 S— 1. 364, os¢-4,385,670- Other ge _ 0 Totals 6,286,046 Habis —$;286,046~- Si4d622 Private and other: Ancillary cost centers: : Physical therapy 447,651 0 147,651 | Speech therapy 50,520 ie} 50,520 j Occupational therapy 84,683 0 84,683 Audiological therapy 0 0 8 Medical supplies 8,444 Th 8,444 Other . 125,643 Gan te) o> 38.153 ~426,642- Room and board 995,210 (275) A9t.435 ~-998,240-- . Other 0 0 — Totals 1,442,151 (Sites) ASH 1,324,786 j Total charges $10,304,883 $ =e $40,304 883— (233,373) 10,071,010 AILIRA naa SEP-{4-01 FRI 02:19 PM KINDRED FAX NO, 5964108 P, 05 East Manor Medical Care Center Aggendix 8 Schedule of Charges For the year ended May 31, 1997 Increase As Reported (Decrease) As Adjusted Usual and customary daily rate $ 137.91 $ —0,00— S470 ; Ay See (7.41) 130.00 Patient charges: Medicaid: Ancillary cost centers: & Physical therapy $ 29,670 3 (20-670). $ 24,c7> 2. Speech therapy 15,048 & 46,048) Ste 0 Occupational therapy 20,145 a ~BOA4S) DNS 0 Audiological therapy 0 ie] ie) Medica! supplies 31,980 - 0 31,980 Other 10,752 iS. 6M 40752 geucg —w Room and board 3,564,584 (5 gquy —S- 3,549,419 S64, 5S4~ Other o 0 Totals __ 3672179 ESSE Medicare: 3.612.174 Ancillary cost centers: Physical therapy 357,548 Ay -23,878- 351549 —Se%e4e- Speech therapy 118,154 & —tO48- eis, R440 Occupational therapy 184,608 + -BO44S- 184,608 -204-262- Audiofogical therapy 0 0 0 Medical supplies 40,180 (e) 10,180 Other 169,973 (45,340) ~40,762- (24. 033 -480,726~ Room and board 861,104 (26s) —O- $60,976 B64 404+ Other 0 0 0 Totals 4,309,551 78,845— ARS ATE (45.605) 1,353,996 Private and other: Ancillary cost centers: Physical therapy 47,751 is) 47,751 Speech therapy 4,704 0 4,704 Occupational! therapy 12,684 0 12,684 Audiological therapy 0 im 0 Medical supplies 11,262 8 11,262 Other 83,307 (4 4s) O38 08886R _| Room and board 652,741 C7) C682. 852 FAL "Other 0 9 0 Totals 782,609 Casasn) 8 (137,607) 782 509— Total charges $5,854,249 $ = S884 (40.507) 5,163,142 : ‘ . NH9Q-092M Tha arrarmnanvina nates are an intearal oart of this schedule. “pene wr: poem i te ee = a te prcoe gem seer FAX NO, 5964108 P. 08 Append x C SEP-{4-01 FRI 02:20 PM KINDRED Menorah House Schedule of Charges For the year ended May 31, 1997 Increase As Reported (Decrease) As Adjusted Usual and customary daily rate $ 201.16 360-0 SRO (12.95) \FZ_3 Patient charges: Medicaid: Ancillary cost centers: Physical therapy $ 18,240 $ 0 $ 16,240 Speech therapy 2,120 i?) 9,120 Occupational therapy 6,060 0 6,060 Audiological therapy 0 0 0 Medical supplies 5,822 . 0 5,822 Other 47,851 670 AEBS 24 524 9 Room and board 4,116,279 Li\,670) —-O— 4 tot Go -AHS2FO- Other 0 0 Totals 4,171,372 a >44854- A483 524° Medicare: SAUTE Ancillary cost centers: Physical therepy 656,868 0 658,888 Speech therapy 99,840 9 99,840 Occupational therapy 438,905 0 438,905 Audiological therapy ; 0 0 0 Medical supplies 8,429 ie} 8,429 Other 249,405 (123,069) 483,048} (16536 466,350 Room and board 4,346,832 0 4,348,832 Otner 0 0 0 Totals 2,800,299 (123.964) (88,046) aca 4,911,230 Private and other: Ancillary cost centers: Pnysical therapy 402,855 ie) 102,855 Speech therapy 8,910 0 8,910 Occupational therapy 42,330 . 0 42,330 Audiological therapy 0 0 0 Medical supplies 4,442 0 4,442 Other 452,473 Clos.to0) «8-H OTF HER 4FE- Room and board 4,386,367 0 4,385,367 Other oO _ Totals 1,697,377 Qoeeoo) 8-88. HESS Total charges S$ 8,669,048 $ --490,890- $ ESS 46 (231.469) $437,514 NLIOO_ NOAM mer wep or va SEP-14-01 FRI 02:20 PM KINDRED FAX NO, 5964108 P, 07 . The Oaks at Avon Nursing and Rehabilitation Center Appendix D Schedule of Charges For the year ended June 30, 1997 Increase : As Reported (Decrease) As Adjusted Usual and customary daily rate 3S 134304 «SSO $ 13425. —— — > (6.16) [29 of Patient charges: Medicaid: Ancillary cost centers: Physical therapy S$ 0 $ 0 $ 0 Speech therapy 0 fs) 0 Occupational therapy 0 0 0 Audiclogical therapy 0 (0) fe Medical supplies , 5,305 - 0 5,305 Other 5,184 0G 10,003 —S484. Room and board 2,515,012 C%BIV) -O 25:43 2,546,042. Other 0 0 0 Totals 2,525,501 0 2,525,501 Medicare: Ancillary cost centers: Physical therapy 4,228,233 0 1,228,233 Speech therapy 365,208 0 365,208 Occupational therapy 988,500 0 988,500 Audiological therapy 0 0 0 Medica! supplies 21,626 0 21,626 Other : 1,041,865 = ((05.222) —S z¢g43 -L04885. Room and board 1,569,305 (MO.6%41) — -O~ .525,006 —H589,308 Other 0 0 0 Totals 5,214,737 Qasaai) 2 S244 BE Oo, S 068.216 Private and other: Ancillary cost centers: Physical therapy 6,051 0 6,051 Speech therapy 1,674 is) 1,674 Occupational therapy 2,982 _0 2,982 Audiological therapy 0 0 0 Medical suppties 2,652 0 2,652 Other 59,198 (S204) - = 6,144 69408 Room and board 1,095,503 QZ) 8 1,041. 37 ~-4096;503- Other OT Totals 4,168,080 £53,553) — int son —ht68,060- Total charges $8,908,298 So TS _ —8,008,208- (194.479) $108.84 hn a nen neta n nen nn intaneet nod af thie eshadila NH99-095M RAE LE aR REE Re Te EE ORE eR Ie RR eRe i A A A ee ae mer ret eee ae es co rem SEP-{4-01 FRI 02:21 PM KINDRED FAX NO. 5964108 P, 08 Bay Pointe Nursing Pavilion Append x E Schedule of Charges For the year ended May 31, 1997 Increase As Reported (Decrease) As Adjusted Usual and customary daily rate 3S 185.00" S000 Ss —485.99- : Cr0.44 116, Patient charges: Medicaid: Ancillary cost centers: . Soa SB Physical therapy $ 20,690 3 ) $ 20690 Speech therapy : 9,495 0 9,495 Occupational therapy 8,720 0 8,720 Audiological therapy 0 0 0 Medical supplies . ; 65,618 - 0 65,618 Other . 5,527 WSS -& 24079 —8.507. Room and board 3.474.678 = CZ1.S4S) 8 3450133 -B474-678- Other - 0 0 0 Totals 3,581,728 0 3,581,728 Medicare: Ancillary cost centers: Physical therapy 431,059 ie) 431,059 Speech therapy 344,070 0 344,070 Occupational therapy : 311,995 0 311,995 Audiological therapy 0 0 0 Medical supplies 19,240 0 19,240 Other 318,148 CH.497) 8 ais) —S4ed4e- Room and board 461,207 Cua) 4454429 “4620 Other ie) G 0 Totals 1,885,749 (13.776) A885,740- : VSI A43 Private and other: Ancillary cost centers: Physical therapy 138,486 0 138,486 Speech therapy 71,370 0. 71,370 Occupational therapy ; 85,640 ; 0 85,640 Audiological therapy 0 0 0 Medical supplies . 18,023 0 18,023 Other 97,880 Colzait\ -O- 36,596 —97,880- : Room and board 719,775 (2.504) -- 111,27) 249.776 é Other : o a Totals 4,131,174 (63,798) 8 1.067.376 “HH Total charges $6,598,624 $ ae SSE eA (134.514) GNGLONT NHS9-163M = pt tha eaten nen ae fata eel nat Afthie enhadiula REET ERATE RMU RE RT eR ep mnt ee ee pe ro |

Docket for Case No: 00-004769