STATE OF FLORIDA . AGENCY FOR HEALTH CARE ADMINISTRATION ; cA D ST CLERK DELTA HEALTH CARE —_ GROUP, INC., Omi RWIS ; Qo Petitioner, closed - we Th TP, ro) : i <= se vs. DOAH CASENO. 01-4992384 F § Tee We, 4 Te 11Be= + <3 1-1731EA ‘ _ i « 01-1732, i Audit No. Rendition No. AHCA-01-205s-- MSA AGENCY FOR HEALTH CARE he ADMINISTRATION, } Respondent. . / ia FINAL ORDER , THE PARTIES resolved all disputed issues and executed a settlement agreement which is attached and incorporated by reference. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is CLOSED. DONE AND ORDERED on this the gt day of November , 2001, in Tallahassee, Florida. re ~ Rhonda M. Medows, MD, PAAFP, 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 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 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. Copies Furnished to: Tim Nicholson Delta Health Group, Inc. One Pensacola Plaza, Suite 400 Pensacola, FL 32501 Kelly A. Bennett, Esquire Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 Barbara J. Staros Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Bob Sharpe, Medicaid Director Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #8 Tallahassee, Florida 32308 Finance & Accounting epg py eo wenn ier Se ed aids eee a ee Se RM eee sere pee eee ee 2 ere CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the persons and entities listed above, by U.S. Mail or by interoffice delivery, on this Boeday of Maitmbhir _, 2001. Diane A. Grubbs, Agency Clerk State of Florida, Agency for i Health Care Administration ' 2727 Mahan Drive, Suite 3431 Fort Knox Building III, MS 3 Tallahassee, Florida 32308 850/922-5865 AUG-83-2881 18:32 AGENCY FOR HEALTH CARE AD 858 4135 9313 P.83 STATE OF FLORIDA liicery DIVISION OF ADMINISTRATIVE HEARIN Yep th Set 7 “Say/ 6 20, DELTA HEALTH CARE GROUP, INC., Petitioner, DOAH CASE NOS: 01-1728 01-1729 01-1730 01-1731 01-1732 v. JUDGE: Barbara J. Staras AGENCY FOR HEALTH CARE ADMINISTRATION, > = Respondent. Bas SS ae / Bee FP gee 2 aw aS oy» © SETTLEMENT AGREEMENT = ooo m wo STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and DELTA HEALTH CARE GROUP, INC., (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered into between the parties for the purpose of avoiding the costs and burdens of litigation. 2. PROVIDER is 2 Medicaid provider in the State of Florida, operating nursing homes that were the subject of audits by the Agency. 3. The Agency conducted andits of the 1997 and 1998 cost reports from the Glencove Nursing Pavilion, a Panama City, Florida, facility. The Agency also conducted audits of the 1997 and 1998 cost reports from the Nursing Pavilion at Chipola, a Marianna, Florida, facility. Also the subject of these proceedings was wr PO RR NR Rm RE Ere oe ange re aR ere per oqene AUG-@3-2881 18:32 AGENCY FOR HEALTH CARE AD 858 413 9313 P.@4 the Agency’s audit of the 1998 cost report from the Delta Health Care Center of Tampa, a Tampa, Florida, facility. In its five Audit Reports issued on March 26, 2001, AHCA notified PROVIDER that review of the cost reports revealed that, in its opinion, some claims in whole or in part were not covered by Medicaid. The Agency further notified PROVIDER of the adjustments which AHCA was making to the cost reports. In response to the Audit Reports, PROVIDER filed five petitions for a formal administrative hearing that were assigned DOAH Case Nos. 01-1728 through 01- 1732, and which were consolidated for purposes of an administrative hearing. By way of its petitions for formal administrative hearings, PROVIDER identified specific adjustments that it appealed. Subsequent to issuance of the Audit Report, AHCA and PROVIDER exchanged documents and discussed each of the adjustments that were at issue. As a result of the aforementioned exchanges, the parties agree that the Agencies adjustments which were the subject of these proceedings, as they relate to the 1997 cost report from the Glencove Nursing Pavilion (audit # NH99-1 33M), shall be resolved as follows: a. Adjustment #8 has been removed. b. Adjustment #9 has been removed. c. Adjustment #14 has been removed. d. Adjustment #16 has been stipulated to by the PROVIDER. e. Adjustment #19 has been removed. FAT RE RRR CRN RE IE AEE eee AUG-23-2001 10:32 AGENCY FOR HEALTH CARE AD 850 413 9313 f. Adjustment relating to the square footage has been stipulated to by the PROVIDER. g. Adjustment relating to acquisition costs and depreciation is resolved by stipulation that $3,288 of the disallowed acquisition costs will be placed in expenses. As a result of the aforementioned exchanges, the parties agree that the Agencies adjustments which were the subject of these proceedings, as they relate to the 1997 cost report from the Nursing Pavilion at Chipola (audit # NH99-135M), shall be resolved as follows: a. Adjustment #2 has been reduced from ($60,515) to ($17,620). b. Cc. g. h. Adjustment #3 has been removed. Adjustment #5 has been removed. _ Adjustment #6 has been reduced from ($202,366) to ($55,868). Adjustment #8 has been removed. Adjustment #9 has been reduced from ($66,193) to ($23,270). Adjustment #10 has been reduced from ($10,790) to ($7,699). Adjustment #16 has been removed. As a result of the aforementioned exchanges, the parties agree that the Agencies adjustments which were the subject of these proceedings, as they relate to the 1998 cost report from the Nursing Pavilion at Chipola (audit # NH99-136M), shall be resolved as follows: a. Adjustment #3 has been reduced from ($45,326) to ($36,334). b. Adjustment #4 has been removed. P.@S rr dal ON I a i ogee ep See Pager SRE ope Se RR ca ote ee ee AUG-83-2861 10:32 AGENCY FOR HEALTH CARE AD 858 413 9313 10. 11. c. Adjustment #10 has been reduced from ($204,549) to ($42,044). d, Adjustment #17 has been stipulated to by the PROVIDER. e. Adjustment #19 has been removed. f. Adjustment #20 has been reduced from ($2,086) to ($1,121). g. Adjustment #23 has been removed. h. Adjustment relating to capital additions has been stipulated to by the PROVIDER. As a result of the aforementioned exchanges, the parties agree that the Agencies adjustments which were the subject of these proceedings, as they relate to the 1998 cost teport from the Delta Health Care Center of Tampa (audit # NH99- 162M), shall be resolved as follows: a. Adjustment #3 has been removed. b. Adjustment #5 has been stipulated to by the PROVIDER. c. Adjustment #6 has been stipulated to by the PROVIDER, d. Adjustment #8 has been stipulated to by the PROVIDER. e. Adjustment #9 has been stipulated to by the PROVIDER, £ Adjustment relating to the square footage has been stipulated to by the PROVIDER. g. Adjustment relating to the acquisition costs and depriciation has been stipulated to by the PROVIDER. As a result of the aforementioned exchanges, the parties agree that the Agencies adjustments which were the subject of these proceedings, as they relate to the ~N nN CPT ESET EP CN TIE SC ERE Ce ORE ee eee UG-83-2001 18:33 12. 13. 14, 1998 cost report from the Glencove Nursing Pavilion (audit # NH99-134M), shall be resolved as follows; a. Adjustment #1 has been stipulated to by the PROVIDER. b. Adjustment #3 has been stipulated to by the PROVIDER. c. Adjustment #4 has been removed. d. Adjustment #6 has been removed, e. Adjustment #10 has been stipulated to by the PROVIDER. f. Adjustment #18 has been removed. In order to resolve this matter without further administrative praceedings, PROVIDER and AHCA expressly agree that the adjustment resolution, as set forth above, will resolve and settle this case completely and release both parties from all liabilities arising from the findings in the audits referenced as: NH99- 162M, NH99-133M, NH99-134M, NH99-135M, and NH99-136M. PROVIDER further agrees that the Agency shall recaleulate the per diem rate for these time periods, and that where PROVIDER was overpaid, PROVIDER will remit payment to the Agency in the full amount of the overpayment within forty- five (45) days of such notice. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 And payment shall clearly indicate that it is per a settlement agreement, shall reference the DOAH Case Number, and shall reference the audit number. AGENCY FOR HEALTH CARE AD 8543 415 9313 P.a? semmewr omer grapes teen tor PORT gee PRP ERE oe eee A I hE bd 4 (cad ii take AUG-83-2881 18:33 AGENCY FOR HEALTH CARE AD 858 413 9313 P.@8 15. 16. 17. 18. 19. 20. PROVIDER agrees that failure to pay any monies due and owing under the terms of this Agreement shall constitute PROVIDER’S authorization for the Agency, without further notice, to withhold the total temaining amount due under the tens of this agreement from any monies due and owing to PROVIDER for any Medicaid claims. AHCA reserves the right to enforce this Agreement under the laws of the State of Florida, the Rules of the Medicaid Program, and all other applicable rules and Regulations. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. . However, the parties believe that this matter should be settled because the parties have agreed to the terms contained within this agreement. Each party shall bear its own attorneys’ fees and costs, if any. The signatories to this Agreement, acting in a representative capacity, represent that they are duly authorized to enter into this Agreement on behalf of the respective parties. Furthermore, PROVIDER agrees that his signature alone binds him to make the payment as set forth in this agreement. The parties further agree that a facsimile or photocopy reproduction of this agreement with PROVIDER’S signature shall be sufficient for the Agency to enforce the agreement and to cancel the hearing in this matter. This Agreement shal] be construed in accordance with the provisions of the laws of Florida. Venue for any action arising from this Agreement shall be in Leon County, Florida. wer or RTT oe pga 1O-16-O1;311:31AM; OCT-@5-2081 11:27 AGENCY FOR HEALTH CARE AD ° 858 413 9313 P.a2 3v 22. 23. 24. -—Deleted by agreement of the parties, This Agreement constitutes the entire agreement between PROVIDER and the AHCA, including anyone acting for, associated with or employed by them, - conceming all matters and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between PROVIDER and the AHCA other than as set forth herein, No modification or waiver of any provision shall be valid unless a written amendment to the Agreement is completed and properly executed by the parties. . This is an Agreement of settlement and compromise, made in recognition that the partics may have different or incorrect understandings, information and contentions, as to facts and law, and with each party compromising and settling any potential correctness or incorrectness of its understandings, information and contentions as to facts and law, so that no misunderstanding or misinformation shall be a ground for rescission hereof. PROVIDER expressly waives in this matter its right to any hearing pursuant to sections 120.569 or 120.57, Florida Statutes, the making of findings of fact and conclusions of law by the Agency, and all further and other proceedings to which it may be entitled by law or rules of the Agency regarding this proceeding and any and all issues raised herein. PROVIDER further agrees that the Agency should TOTAL P.@2 ree wees cS calc A a aol Cre EEE ERR iad desided canis aatnes att dete PERTTI TY REE Pompe ccs AUG~B3-2881 18:33 25. 26. 27. AGENCY FOR HEALTH CARE AD 850 413 9313 P.1a issue a Final Order which is consistent with the terms of this settlement, that adopts this agreement and closes this matter. This Agreement is and shall be deemed jointly drafted and written by all parties to it and shall not be construed or interpreted against the party originating or preparing it. To the extent that any provision of this Agreement is prohibited by law for any reason, such provision shall be effective to the extent not so prohibited, and such prohibition shall not affect any other provision of this Agreement. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, Tepresentatives and trustees, Cyr + , AUG-G3-2881 18:33 AGENCY FOR HEALTH CARE AD 858 413 9313 P.i4 28. All times stated herein are of the essence of this Agreement. 29. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. DELTA HEALTH CARE GROUP, INC. . Mr. Tim Nicholson Petitioner/Provider AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Rufus Noble Inspector General dene, General Counsel Kelfy A. B&inett Assistant General Counsel Dated: Disa j yy 3, , 2001 Dated: , 2001 TOTAL P.1it aren

Docket for Case No: 01-001729